Mariam Nassar

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5502005496 Issued in MI

Practice address

25775 W 10 Mile Rd Ste C
Southfield, MI 48033-4856

Phone

(248) 809-9941

NPI assigned

Dec 20, 2017

Sex

Female

Sole proprietor

Yes

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

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Michigan Luna Care Physical Therapy, LLC

  • Physical Therapist
  • Ann Arbor, MI
  • NPI 1003448994
  Medicare reassignment

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

{
    "created_epoch": "1513728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513728000000",
    "number": "1467968933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25775 W 10 MILE RD STE C",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480334856",
            "telephone_number": "248-809-9941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25775 W 10 MILE RD STE C",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480334856",
            "telephone_number": "248-809-9941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASSAR",
        "first_name": "MARIAM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-20",
        "last_updated": "2017-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502005496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanna R Nash
• Domenique Nash
• Roseanna Nash
• Iqbal Nasir, MD
• Lara Nassar
• Abtahal Nasser
• Mariam Nasser, MD
• Patrick Nassrallah, MD
• Natalie Savoy PLLC
• Nathaniel Davis,DDS,PC

• Physical Therapy Assistant in Southfield, MI
• Providers in Southfield, MI by specialty
• Physical Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.