Alieu Essa Jallow

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704285372 Issued in MI

Practice address

1408 Mill Pond Dr
Waterford, MI 48327-3088

Phone

(248) 767-3405

NPI assigned

Nov 20, 2023

Sex

Male

Sole proprietor

Yes

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

Specialty

Nurse Practitioner

Education

Wayne State University School of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Detroit Medical Consultants PCGroup PAC ID 3678854866, 13 clinicians

Mdslivenow PLLCGroup PAC ID 7214323336, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Detroit Medical Consultants PC

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1609229848

  MI

  Medicare reassignment Care Compare group NPD
• Mdslivenow PLLC

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1215688965

  MI

  Medicare reassignment Care Compare group NPD
• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  MI

  Medicare reassignment NPD
• Jallow Kia Enterprise LLC

  • Nursing Care Agency
  • Waterford, MI
  • NPI 1063207504
  NPD Authorized official
• New Dimensions Behavioral Health Services, LLC

  • Community/Behavioral Health Agency
  • Waterford, MI
  • NPI 1396622049
  NPD Authorized official
• Alliance Family Health PLLC

  • Internal Medicine Physician
  • Pontiac, MI
  • NPI 1235098260

  MI

  Medicare reassignment
• Alliance Health Physicians PLLC

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1346038189

  MI

  Medicare reassignment
• Alliance Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Pontiac, MI
  • NPI 1548129588

  MI

  Medicare reassignment
• Shamael Haque, D.O., PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Canton, MI
  • NPI 1265295653

  MI

  Medicare reassignment

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

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1497520480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 MILL POND DR",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483273088",
            "telephone_number": "248-767-3405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 MILL POND DR",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483273088",
            "telephone_number": "248-767-3405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JALLOW",
        "first_name": "ALIEU",
        "middle_name": "ESSA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-20",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704285372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jibu Jacob
• Jacqueline C Vaughn DC PC
• Rutuja Hambirrao Jadhav, MS
• Jerome Alan Jaffee, DDS
• Jallow Kia Enterprise LLC
• James a. Gibson, M.D., P.C.
• James E. Locascio, D.D.S.P.C.
• Jasmine Jamoua
• Jack D Janigian, DPM
• Jas Consultants

• Psychiatric/Mental Health Nurse Practitioner in Waterford, MI
• Providers in Waterford, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.