Individual provider Active NPI

Tarik Atif Ali, DO

  • Family Medicine Physician
  • Detroit, MI
National Provider Identifier
1477068310
Registry record updated Nov 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101025422 Issued in MI
Practice address
5901 W Vernor Hwy
Detroit, MI 48209-2180
Phone
(313) 554-4357
Fax
(313) 554-1565
NPI assigned
Dec 13, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 5101025422 MI Primary

Addresses

Primary practice location

5901 W Vernor Hwy
Detroit, MI 48209-2180

Mailing address

15408 Auburndale St
Livonia, MI 48154-3128
Phone (734) 788-9466

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200930002758 MI Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 9931528585 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Michigan State University College of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1 Vans Ave
Coldwater, MI 49036-1724
Phone (313) 413-3709

24680 Swanson Rd
Suite a
Southfield, MI 48033-2415
Phone (313) 413-3709

28651 Hoover Rd
Warren, MI 48093-4105

28653 Hoover Rd
Warren, MI 48093-4105
Phone (313) 413-3709

9925 Dix
Suite 103
Dearborn, MI 48120-1593
Phone (313) 413-3709

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Ali Health Urgent Care PLLC Single Specialty CurrentSince May 2, 2023 Accepting new patients
Aoun Medical Group PLLC Single Specialty CurrentSince Sep 2, 2021 Accepting new patients
Ali Health Primary Care PLLC Single Specialty CurrentSince May 3, 2023 Accepting new patients
Modini Liyanage PLLC Single Specialty CurrentSince Jul 5, 2023 Accepting new patients
Tri-Unity Infusion Services, LLC Past Accepting new patients
Henry Ford Health Macomb-Oakland Hospital Past Accepting new patients

Locations

1 Vans Ave
Coldwater, MI 49036
Phone (313) 413-3709

9925 Dix
Ste 103
Dearborn, MI 48120
Phone (313) 413-3709

9925 Dix
Ste 102
Dearborn, MI 48120
Phone (313) 377-6396

5901 W Vernor Hwy
Detroit, MI 48209
Phone (313) 207-5767

28653 Hoover Rd
Warren, MI 48093
Phone (313) 413-3709

28651 Hoover Rd
Warren, MI 48093
Phone (313) 413-3709

1203 S Wayne Rd
Westland, MI 48186
Phone (248) 719-8117

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22896/brand/1/csg/1/fhir/r4
  • Direct secure messaging: tarik.ali.1@29427.direct.athenahealth.com

Organizations & group practices 6

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": "1513123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637452800000",
    "number": "1477068310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15408 AUBURNDALE ST",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481543128",
            "telephone_number": "734-788-9466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 W VERNOR HWY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482092180",
            "telephone_number": "313-554-4357",
            "fax_number": "313-554-1565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "TARIK",
        "middle_name": "ATIF",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-13",
        "last_updated": "2021-11-21",
        "certification_date": "2021-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101025422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.