Active NPI
Ahmed H Aly-Abdel-Latif, RN
- Certified Registered Nurse Anesthetist
- West Bloomfield, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 4704293356
- Practice address
- 5146 Parkside Dr
West Bloomfield, MI 48323-2169 - Phone
- (313) 434-6667
- NPI assigned
- Jul 12, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 4704293356 | MI | |
| Certified Registered Nurse Anesthetist | 367500000X | 4704293356 | MI | Primary |
Addresses
Primary practice location
5146 Parkside Dr
West Bloomfield, MI 48323-2169
Mailing address
5146 Parkside Dr
West Bloomfield, MI 48323-2169
Phone (313) 434-6667
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221122001486 | MI | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 6800264946 | Reassigns benefits to 4 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Resource Anesthesiology Associates of Mi PC
Practice addresses (Care Compare)
200 Hemlock St
Tawas City, MI 48763-9237
Phone (989) 362-3411
Hospital & facility affiliations
- Mymichigan Medical Center Saginaw
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704293356 | MI | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mymichigan Medical Center Midland | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Henry Ford Health System | Current | Accepting new patients | |
| Mymichigan Medical Center Midland | Current | Accepting new patients | |
| Henry Ford Health System | Nurse Anesthetist, Certified Registered | Current | Accepting new patients |
| Pediatric Anesthesia Associates, PC | Current | Accepting new patients | |
| Resource Anesthesiology Associates of Mi PC | Current | Accepting new patients | |
| Crnas of Michigan | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Locations
3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227
2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062
4000 Wellness Dr
Midland, MI 48670
Phone (844) 832-1956
826 W King St
Owosso, MI 48867
Phone (989) 720-2273
800 S Washington Ave
Saginaw, MI 48601
Phone (989) 776-8000
200 Hemlock St
Tawas City, MI 48763
Phone (989) 362-0153
L4355
Columbus, OH 43260
Organizations & group practices 7
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.
-
- Certified Registered Nurse Anesthetist
- Detroit, MI
- NPI 1871666479
MI, Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Midland, MI
- NPI 1770668683
MI, Nurse Anesthetist, Certified Registered
-
- Community/Retail Pharmacy
- Plymouth, MI
- NPI 1942931720
-
- Anesthesiology Physician
- Midland, MI
- NPI 1649010455
-
- Certified Registered Nurse Anesthetist
- Detroit, MI
- NPI 1457666828
Nurse Anesthetist, Certified Registered
Hospital & facility affiliations 1
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": "1626048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734998400000",
"number": "1619549482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5146 PARKSIDE DR",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483232169",
"telephone_number": "313-434-6667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5146 PARKSIDE DR",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483232169",
"telephone_number": "313-434-6667"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALY-ABDEL-LATIF",
"first_name": "AHMED",
"middle_name": "H",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-07-12",
"last_updated": "2024-12-24",
"certification_date": "2024-12-24",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MI",
"license": "4704293356",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MI",
"license": "4704293356",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Bloomfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.