Balsam Al Balaghi, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601007353 Issued in MI

Practice address

6071 W Outer Dr
Detroit, MI 48235-2624

Phone

(313) 966-3300

NPI assigned

May 13, 2015

Last updated

Nov 19, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: balbalag@direct.dmc.org
• Direct secure messaging: balbalaghi553710@direct.hfhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  • NPI 1366565442
  Medicare reassignment
• Pioneer Medical Group PLLC

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1801304688
  Medicare reassignment

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

{
    "created_epoch": "1431475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447891200000",
    "number": "1497133102",
    "addresses": [
        {
            "country_code": "CA",
            "country_name": "Canada",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "6071W OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352624",
            "telephone_number": "313-966-4750",
            "fax_number": "313-966-4760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6071 W OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352624",
            "telephone_number": "313-966-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL BALAGHI",
        "first_name": "BALSAM",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-13",
        "last_updated": "2015-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Okey Anthony Akwanamnye
• Bashar Mohammad Al a'Amar
• Morhaf Al Achkar, MD
• Shada Al Anani, MD
• Rola Bassam Al Assi
• Randa Al Barazi, MD
• Fadi Khalil Al Daoud, M.D
• Rayan M Al Edreesi, BDS
• Mona Abdullah Al Fares, M.D.
• Farah Mohammed Al Haj, M.D.

• Physician Assistant in Detroit, MI
• Providers in Detroit, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.