Individual provider Active NPI

Vali Hakeem

  • Physician Assistant
  • Detroit, MI
National Provider Identifier
1417763467
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601013211 Issued in MI
Practice address
259 Mack Ave
Detroit, MI 48201-2427
Phone
(313) 577-1716
NPI assigned
Dec 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601013211 MI Primary

Addresses

Primary practice location

259 Mack Ave
Detroit, MI 48201-2427

Mailing address

259 Mack Ave
Detroit, MI 48201-2427
Phone (313) 577-1716

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250620002635 MI Practitioner - Physician Assistant 8426560913 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5601013211MIMDPhysician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1733270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1417763467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012427",
            "telephone_number": "313-577-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012427",
            "telephone_number": "313-577-1716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAKEEM",
        "first_name": "VALI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-04",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601013211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.