Tasneem Ali

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Wyoming, MI

NPI 1629864095 · NPPES record last updated Apr 15, 2025

Key facts

NPI
1629864095
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
5900 Byron Center Ave SW
Wyoming, MI 49519-9606
Phone
(616) 252-7078
Fax
(616) 252-4953
NPI assigned
Apr 15, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20250715002071 MI Order and Referring Only - Family Practice
Practitioner - Family Practice
3870008295

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

5900 Byron Center Ave SW
Wyoming, MI 49519-9606

Mailing address

5900 Byron Center Ave SW
Wyoming, MI 49519-9606
Phone (616) 252-7078

Other providers in Wyoming, MI

All providers in Wyoming, MI · Student in an Organized Health Care Education/Training Program in Michigan

Sources for this page

Verify at the official NPI Registry.