Individual provider Active NPI

Wassim Noureddine, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Jackson, MI
National Provider Identifier
1548421167
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
4301097637 Issued in MI
Practice address
3333 Spring Arbor Rd Ste 100
Jackson, MI 49203-8602
Phone
(517) 205-1000
NPI assigned
Jun 17, 2008
Last updated
Oct 28, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301097637 MI
Internal Medicine Physician 207R00000X 036120723 IL
Internal Medicine Physician 207R00000X MD438106 PA
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 4301097637 MI Primary

Addresses

Primary practice location

3333 Spring Arbor Rd Ste 100
Jackson, MI 49203-8602

Mailing address

1 Ford PL Ste 3a
Detroit, MI 48202-3450
Phone (313) 874-4806

Other practice location 1

120 N Washington Sq Ste 300
Lansing, MI 48933-1658
Phone (630) 933-2489

Other identifiers 3

IdentifierTypeStateIssuer
0222075OtherILBLUE CROSS GROUP NUMBER
3631498336019001OtherILCDPG HFS PAYEE ID
036120723MedicaidIL

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
I20110209000831 MI Practitioner - HospitalistPractitioner - Internal Medicine 7113094905 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Wayne State University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3333 Spring Arbor Rd
Suite 100
Jackson, MI 49203-8602
Phone (517) 205-2775

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD438106PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Inpatient Physicians-Michigan, PLLC Family Medicine CurrentSince Jun 1, 2015 Accepting new patients
Iha Health Services Corporation Hospitalist CurrentSince Mar 12, 2012 Accepting new patients
Sound Inpatient Physicians - Michigan, PLLC Family Medicine CurrentSince Jun 1, 2015 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
Vituity - Michigan Hospitalists PC Family Medicine CurrentSince Nov 1, 2020 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Oct 1, 2022 Accepting new patients
W. a. Foote Memorial Hospital, Inc Internal Medicine Current Accepting new patients
W.a. Foote Memorial Hospital, Inc Endocrinology, Diabetes & Metabolism CurrentSince Oct 1, 2022 Accepting new patients
Iha Health Service Corporation CurrentSince Mar 12, 2012 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

406 E Elm St
Carson City, MI 48811
Phone (517) 584-3131

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

3333 Spring Arbor Rd
Ste 100
Jackson, MI 49203
Phone (517) 205-2156

813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

1 Atkinson Dr
Ludington, MI 49431
Phone (231) 843-2591

580 W College Ave
Marquette, MI 49855
Phone (906) 225-3131

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

Interoperability endpoints

  • Direct secure messaging: wnoureddine61909@direct.hfhs.org

Organizations & group practices 9

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1548421167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-874-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 SPRING ARBOR RD STE 100",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492038602",
            "telephone_number": "517-205-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 N Washington Sq Ste 300",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489331658",
            "country_code": "US",
            "telephone_number": "630-933-2489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOUREDDINE",
        "first_name": "WASSIM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-17",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301097637",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036120723",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD438106",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MI",
            "license": "4301097637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP NUMBER",
            "identifier": "0222075",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPG HFS PAYEE ID",
            "identifier": "3631498336019001",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036120723",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.