Individual provider Active NPI

Yusra Al Riyami

  • Student in an Organized Health Care Education/Training Program
  • Warren, MI
National Provider Identifier
1548041817
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
11900 E 12 Mile Rd Ste 210
Warren, MI 48093-3490
Phone
(586) 582-7100
Fax
(586) 582-7107
NPI assigned
Oct 11, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

11900 E 12 Mile Rd Ste 210
Warren, MI 48093-3490

Mailing address

11900 E 12 Mile Rd Ste 210
Warren, MI 48093-3490
Phone (586) 582-7100

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
I20231102001697 MI Order and Referring Only - Maxillofacial SurgeryPractitioner - Maxillofacial Surgery 8426404088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1696982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1548041817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11900 E 12 MILE RD STE 210",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933490",
            "telephone_number": "586-582-7100",
            "fax_number": "586-582-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 E 12 MILE RD STE 210",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933490",
            "telephone_number": "586-582-7100",
            "fax_number": "586-582-7107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL RIYAMI",
        "first_name": "YUSRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-11",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.