Individual provider Active NPI

Ali Rida, MD

  • Family Medicine Physician
  • Dearborn, MI
National Provider Identifier
1619460110
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4351038258 Issued in MI
Practice address
23100 Cherry Hill St Ste 9
Dearborn, MI 48124-1449
Phone
(313) 747-2007
Fax
(313) 789-1596
NPI assigned
Jun 8, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4351038258 MI Primary

Addresses

Primary practice location

23100 Cherry Hill St Ste 9
Dearborn, MI 48124-1449

Mailing address

23100 Cherry Hill St Ste 9
Dearborn, MI 48124-1449
Phone (313) 747-2007

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address arida400971@direct.beaumont.educ

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
I20210809002866 MI Practitioner - Family Practice 5597012351 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 2018
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

23100 Cherry Hill St
Suite 9
Dearborn, MI 48124-1449
Phone (313) 747-2007

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4351038258MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Life Beyond MD PLLC Family Medicine CurrentSince Dec 16, 2024 Accepting new patients

Locations

23100 Cherry Hill St
Ste 9
Dearborn, MI 48124
Phone (313) 406-4067

Interoperability endpoints

  • Direct secure messaging: ali.rida@880865294745604.direct.elationemr.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1528416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1619460110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23100 CHERRY HILL ST STE 9",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241449",
            "telephone_number": "313-747-2007",
            "fax_number": "313-789-1596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23100 CHERRY HILL ST STE 9",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241449",
            "telephone_number": "313-747-2007",
            "fax_number": "313-789-1596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIDA",
        "first_name": "ALI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-08",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4351038258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "arida400971@direct.beaumont.educ",
            "affiliation": "N",
            "address_1": "27031 W Warren St",
            "city": "Dearborn Heights",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481271901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.