Individual provider Active NPI

Mohammed Faraj

  • Occupational Therapist
  • Detroit, MI
National Provider Identifier
1477042463
Registry record updated May 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201008866 Issued in MI
Practice address
18901 Meyers Rd
Detroit, MI 48235-1366
Phone
(313) 864-8481
NPI assigned
May 4, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201008866 MI Primary

Addresses

Primary practice location

18901 Meyers Rd
Detroit, MI 48235-1366

Mailing address

18901 Meyers Rd
Detroit, MI 48235-1366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210820002501 MI Practitioner - Occupational Therapist in Private Practice 2264837749 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Outcomes Management,LLC Occupational Therapist CurrentSince Aug 1, 2021 Accepting new patients
Sensory Park Autism Services LLC Occupational Therapist Current Accepting new patients

Locations

210 Town Center Dr
Troy, MI 48084
Phone (248) 643-8900

Organizations & group practices 2

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": "1525392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525392000000",
    "number": "1477042463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18901 MEYERS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482351366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18901 MEYERS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482351366",
            "telephone_number": "313-864-8481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARAJ",
        "first_name": "MOHAMMED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-04",
        "last_updated": "2018-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201008866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.