Individual provider Active NPI

Moammar Y Nasser

  • Family Nurse Practitioner
  • Dearborn Heights, MI
National Provider Identifier
1568342863
Registry record updated Sep 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704358129 Issued in MI
Practice address
25340 Van Born Rd
Dearborn Heights, MI 48125-2011
Phone
(313) 603-2789
NPI assigned
Sep 5, 2025
Last updated
Sep 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704358129 MI Primary

Addresses

Primary practice location

25340 Van Born Rd
Dearborn Heights, MI 48125-2011

Mailing address

25340 Van Born Rd
Dearborn Heights, MI 48125-2011
Phone (313) 395-2865

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251024000402 MI Practitioner - Nurse Practitioner 9739677360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quick Doc Urgent Care PLLCGroup PAC ID 1355870031, 4 clinicians

Practice addresses (Care Compare)

25340 Van Born Rd
Dearborn Heights, MI 48125-2011
Phone (313) 395-2865

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704358129MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Quick Doc Urgent Care PLLC CurrentSince Sep 8, 2025 Accepting new patients

Locations

25340 Van Born Rd
Dearborn Hts, MI 48125
Phone (313) 395-2865

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1757030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757203200000",
    "number": "1568342863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25340 VAN BORN RD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481252011",
            "telephone_number": "313-395-2865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25340 VAN BORN RD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481252011",
            "telephone_number": "313-603-2789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASSER",
        "first_name": "MOAMMAR",
        "middle_name": "Y",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-05",
        "last_updated": "2025-09-07",
        "certification_date": "2025-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704358129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn Heights, MI

Sources for this page

Verify at the official NPI Registry.