Individual provider Active NPI

Ahmed H Aly-Abdel-Latif, RN

  • Certified Registered Nurse Anesthetist
  • West Bloomfield, MI
National Provider Identifier
1619549482
Registry record updated Dec 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704293356 Issued in MI
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

Updated by the provider on Dec 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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 62 clinicians

Practice addresses (Care Compare)

200 Hemlock St
Tawas City, MI 48763-9237
Phone (989) 362-3411

Hospital & facility affiliations

  • Mymichigan Medical Center Saginaw Hospital, Saginaw, MI, CCN 230077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704293356MIMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Mymichigan Medical Center Midland Nurse Anesthetist, Certified Registered CurrentSince Mar 31, 2025 Accepting new patients
Henry Ford Health System CurrentSince May 22, 2023 Accepting new patients
Mymichigan Medical Center Midland CurrentSince Mar 31, 2025 Accepting new patients
Henry Ford Health System Nurse Anesthetist, Certified Registered CurrentSince May 22, 2023 Accepting new patients
Pediatric Anesthesia Associates, PC CurrentSince Jan 1, 2026 Accepting new patients
Resource Anesthesiology Associates of Mi PC CurrentSince May 27, 2023 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.

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.

Verify at the official NPI Registry.