Mohammad Al-Harastani, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301067273 Issued in MI

Practice address

1083 Suncrest Dr
Suite-a
Lapeer, MI 48446-4421

Phone

(810) 245-9700

Fax

(810) 245-9703

NPI assigned

Nov 4, 2005

Last updated

Feb 5, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 14

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Lapeer Pediatrics, P.C.

  • Primary Care Clinic/Center
  • Lapeer, MI
  • NPI 1265623276
  Medicare reassignment NPD Authorized official
• Oxford Urgent Care P L C

  • Specialist
  • Oxford, MI
  • NPI 1700036936
  NPD (past)

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391558400000",
    "number": "1619968922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1083 SUNCREST DR",
            "address_2": "SUITE-A",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484464421",
            "telephone_number": "810-245-9700",
            "fax_number": "810-245-9703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1083 SUNCREST DR",
            "address_2": "SUITE-A",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484464421",
            "telephone_number": "810-245-9700",
            "fax_number": "810-245-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-HARASTANI",
        "first_name": "MOHAMMAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2014-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301067273",
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MI",
            "license": "4301067273",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619968922",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPOM",
            "identifier": "526",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8572330001",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5243111",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "P48210001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS",
            "identifier": "41A87114",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "350D410030",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH PLAN",
            "identifier": "1026494",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "35-0-44-1237-1",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "METRAHEALTH",
            "identifier": "370011198",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCARE",
            "identifier": "C3769",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ADVANTAGE NETWORK",
            "identifier": "1026494",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "305-044-1237-1",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE PLAN",
            "identifier": "F76263",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Antoun Aftimos, M.D.
• Adam Richard Ahlgren
• Hisham Ibrahim Ahmed, M.D.
• Sherry Lou Akers, OTR
• Akram M. Fram, M.D, P.C.
• Sami Al-Harastani
• Stevie M Alamo-Garza
• Abdul Kadar Alawwa, M.D.
• Carrie Nicole Aldrich, MS, LPC
• Adam Alexander

• Pediatrics Physician in Lapeer, MI
• Providers in Lapeer, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.