Masoumeh Khosraviardakani, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

4704276401 Issued in MI

Practice address

4201 Saint Antoine St Ste 8D
Detroit, MI 48201-2153

Phone

(313) 745-4275

Fax

(313) 577-4641

NPI assigned

Aug 11, 2019

Last updated

Aug 11, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Harper University Hospital Hospital, Detroit, MI, CCN 230104
• Sinai-Grace Hospital Hospital, Detroit, MI, CCN 230024
• Detroit Receiving Hospital Hospital, Detroit, MI, CCN 230273
• Rehabilitation Institute of Michigan Inpatient rehabilitation facility, Detroit, MI, CCN 233027

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• University Physician Group

  dba Wayne Health

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1447299797
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• VHS Detroit Receiving Hospital Inc

  dba Detroit Receiving Hospital

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1619289998
  Care Compare affiliation
• VHS Harper-Hutzel Hospital Inc

  dba Harper University Hospital

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1427360700
  Care Compare affiliation
• VHS Rehabilitation Institute of Michigan Inc

  dba Rehabilitation Institute of Michigan

  • Rehabilitation Hospital
  • Detroit, MI
  • NPI 1871805150

  Inpatient rehabilitation facility

  Care Compare affiliation
• VHS Sinai-Grace Hospital Inc

  dba Sinai-Grace Hospital

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1760794044
  Care Compare affiliation

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

{
    "created_epoch": "1565481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565481600000",
    "number": "1467008086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 EAGLE AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481038887",
            "telephone_number": "734-255-0349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SAINT ANTOINE ST STE 8D",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012153",
            "telephone_number": "313-745-4275",
            "fax_number": "313-577-4641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOSRAVIARDAKANI",
        "first_name": "MASOUMEH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-11",
        "last_updated": "2019-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704276401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hazar H Khidir, MD
• Sarah Khishen
• Ali Jihad Khocheiche, PHARMD, MBA
• Sina Khoshbin, M.D.
• Sina Khosravani, DO
• Dania Khoulani
• Amilee Khoury, DO
• Elie Ramzi Khoury, MD
• Fuad Aziz Khoury II, M.D.
• Ishaq Salim Ishaq Khoury, M.D.

• Acute Care Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Acute Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.