Individual provider Active NPI

Manal Assi, MD

  • Psychiatry Physician
  • Ann Arbor, MI
National Provider Identifier
1487669354
Registry record updated Oct 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301066678 Issued in MI
Practice address
2395 Oak Valley Dr
Suite 100
Ann Arbor, MI 48103-8943
Phone
(734) 995-5181
Fax
(734) 995-9011
NPI assigned
Jul 29, 2006
Last updated
Oct 8, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301066678 MI Primary

Addresses

Primary practice location

2395 Oak Valley Dr
Suite 100
Ann Arbor, MI 48103-8943

Mailing address

2395 Oak Valley Dr
Suite 100
Ann Arbor, MI 48103-8943
Phone (734) 995-5181

Other identifiers 1

IdentifierTypeStateIssuer
2608131571OtherMIBCBS OF MI

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
I20041004000925 MI Practitioner - Psychiatry 9032178314 Practice locations: Ann Arbor, MI

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1995
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2395 Oak Valley Dr
Suite 100
Ann Arbor, MI 48103-8943

2395 Oak Valley Dr
Suite 100
Ann Arbor, MI 48103-9118
Phone (734) 995-5181

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301066678MIMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318032000000",
    "number": "1487669354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2395 OAK VALLEY DR",
            "address_2": "SUITE 100",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481038943",
            "telephone_number": "734-995-5181",
            "fax_number": "734-995-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2395 OAK VALLEY DR",
            "address_2": "SUITE 100",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481038943",
            "telephone_number": "734-995-5181",
            "fax_number": "734-995-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASSI",
        "first_name": "MANAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-29",
        "last_updated": "2011-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301066678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI",
            "identifier": "2608131571",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.