Organization Active NPI

Maple Crest Medical PLC

  • Urgent Care Clinic/Center
  • Sterling Heights, MI
National Provider Identifier
1477783702
Registry record updated Jul 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
MAPLE CREST MEDICAL PLC
Practice address
35450 Dequindre Rd
Suite 103
Sterling Heights, MI 48310-4810
Phone
(586) 795-2980
NPI assigned
Jul 21, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2009

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

Authorized official

Name
Dr. Bassam Kinaya, MD
Title
President
Phone
(586) 795-2980

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

35450 Dequindre Rd
Suite 103
Sterling Heights, MI 48310-4810

Mailing address

35450 Dequindre Rd
Suite 103
Sterling Heights, MI 48310-4810
Phone (586) 795-2980

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091110000029 MI Part B Supplier - Clinic/Group Practice 6204974439 Receives reassigned benefits from 1 practitioner
Practice locations: Clinton Township, MI; Sterling Heights, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1248134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248134400000",
    "number": "1477783702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35450 DEQUINDRE RD",
            "address_2": "SUITE 103",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483104810",
            "telephone_number": "586-795-2980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35450 DEQUINDRE RD",
            "address_2": "SUITE 103",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483104810",
            "telephone_number": "586-795-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE CREST MEDICAL PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-21",
        "last_updated": "2009-07-21",
        "status": "A",
        "authorized_official_last_name": "KINAYA",
        "authorized_official_first_name": "BASSAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-795-2980",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; 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.