Individual provider Active NPI

Mariam Shukri David, FNP-C

  • Family Nurse Practitioner
  • Farmington Hills, MI
National Provider Identifier
1629897111
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704339353 Issued in MI
Practice address
24353 Orchard Lake Rd Ste D
Farmington Hills, MI 48336-1917
Phone
(248) 200-3715
NPI assigned
Oct 10, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704339353 MI Primary

Addresses

Primary practice location

24353 Orchard Lake Rd Ste D
Farmington Hills, MI 48336-1917

Mailing address

24353 Orchard Lake Rd Ste D
Farmington Hills, MI 48336-1917
Phone (248) 200-3715

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241112003926 MI Practitioner - Nurse Practitioner 1850825969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ali M Alsaadi MD PCGroup PAC ID 0941205785, 3 clinicians

Practice addresses (Care Compare)

24353 Orchard Lake Rd
Suite D
Farmington Hills, MI 48336-1917
Phone (248) 200-3715

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ali M Alsaadi MD PC CurrentSince Nov 1, 2024 Accepting new patients
Ali Alsaadi MD & Associates PC CurrentSince Nov 1, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mariam.david.1@22658.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/23465/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/22658/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/14284/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1728518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1629897111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24353 ORCHARD LAKE RD STE D",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483361917",
            "telephone_number": "248-200-3715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24353 ORCHARD LAKE RD STE D",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483361917",
            "telephone_number": "248-200-3715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVID",
        "first_name": "MARIAM",
        "middle_name": "SHUKRI",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-10",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704339353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.