Nasser Elsouri, MD

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

4301080157 Issued in MI

Practice address

4646 John R St
11M
Detroit, MI 48201-1916

Phone

(313) 576-3724

NPI assigned

Aug 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, FL, OH, VA, WV5 enrollments

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 5

Specialty

Critical Care (Intensivists)

Education

Ohio University, College of Osteopathic Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Promedica Multi Specialty PhysiciansGroup PAC ID 7113182809, 269 clinicians

Mercy Health Physicians Lima Specialty Care LLCGroup PAC ID 7012332364, 254 clinicians

Camden-Clark Physician CorporationGroup PAC ID 5294885661, 345 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068
• Mercy Health St Ritas Medical Center Hospital, Lima, OH, CCN 360066
• Camden Clark Medical Center Hospital, Parkersburg, WV, CCN 510058

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations (25 of 28)

Interoperability endpoints

• Direct secure messaging: nelsouri177063@direct.covenanthealthcare.com
• Direct secure messaging: nelsouri717851@direct.trinity-health.org

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.

• Camden-Clark Physician Corporation

  • Surgery Physician
  • Parkersburg, WV
  • NPI 1710125430
  Medicare reassignment Care Compare group NPD
• Mercy Health Physicians Lima Specialty Care LLC

  • Surgery Physician
  • Lima, OH
  • NPI 1518589803

  Critical Care Medicine

  Medicare reassignment Care Compare group NPD
• Promedica Multi Specialty Physicians

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1306105150
  Medicare reassignment Care Compare group NPD
• Advantage Health/Saint Mary'S Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1376862151
  Medicare reassignment NPD
• Covenant Medical Center, Inc.

  • Emergency Medicine Physician
  • Saginaw, MI
  • NPI 1972590412
  Medicare reassignment NPD
• Intensive Care Consortium Inc

  • Specialist
  • Aventura, FL
  • NPI 1629019062

  Critical Care Medicine

  Medicare reassignment NPD
• KND Development 59 LLC

  • Hospitalist Physician
  • Dayton, OH
  • NPI 1992034680
  Medicare reassignment NPD
• Nuview Telehealth, LLC

  • Specialist
  • Boca Raton, FL
  • NPI 1538300181

  Internal Medicine

  Medicare reassignment NPD
• Sentara Medical Group

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1265485270

  Internal Medicine

  Medicare reassignment NPD
• Advantage Health Saint Mary'S Medical Group

  • Orthopaedic Surgery Physician
  • Byron Center, MI
  • NPI 1003515008
  NPD
• Advantage Health Saint Mary'S Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1952340911
  NPD
• Covenant Medical Center, Inc

  • Family Medicine Physician
  • Saginaw, MI
  • NPI 1619412376

  Internal Medicine

  NPD

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

• Camden Clark Memorial Hospital Corporation

  • General Acute Care Hospital
  • Parkersburg, WV
  • NPI 1508160268
  Care Compare affiliation
• Camden Clark Memorial Hospital Corporation

  • General Acute Care Hospital
  • Parkersburg, WV
  • NPI 1699704254
  Care Compare affiliation
• Mercy Health-St Ritas Medical Center LLC

  • Psychiatric Hospital Unit
  • Lima, OH
  • NPI 1447276936
  Care Compare affiliation
• Mercy Health-St Ritas Medical Center LLC

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1811939887
  Care Compare affiliation
• The Toledo Hospital

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1407854771
  Care Compare affiliation
• Toledo Hospital

  • Ambulance
  • Toledo, OH
  • NPI 1427147339

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1609885151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4049 GLENCASTLE DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480986342",
            "telephone_number": "313-737-9731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 JOHN R ST",
            "address_2": "11M",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482011916",
            "telephone_number": "313-576-3724"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Coliseum Dr Ste 320",
            "address_purpose": "LOCATION",
            "city": "Hampton",
            "state": "VA",
            "postal_code": "236665983",
            "country_code": "US",
            "telephone_number": "757-827-2350",
            "fax_number": "757-510-9383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELSOURI",
        "first_name": "NASSER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101268545",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301080157",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OH",
            "license": "35135469",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "VA",
            "license": "0101268454",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MI",
            "license": "4301080157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yosra Ehab Elsayed
• Mohamed A. Elshaikh, M.D.
• Mohamed A. Elshayeb, M.D
• Ahmed Elsiddig Abdelrahim Elsiddig
• Elsmar Home Health Care LLC
• Hazem A Eltahawy, MD
• Husam Eltahir, MD
• Mohammed Eltahir, M.D.
• Lynnette Marie Ely Whitfield, LLPC
• Kimberly Elyse, PH.D.

• Critical Care Medicine (Internal Medicine) Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Critical Care Medicine (Internal Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.