Individual provider Active NPI

Yasmeen Imad Ayoub

  • Surgery Physician
  • Detroit, MI
National Provider Identifier
1649064478
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4351054547 Issued in MI
Practice address
22151 Moross Rd Ste 214
Detroit, MI 48236-2151
Phone
(313) 343-4867
Fax
(313) 343-3280
NPI assigned
Apr 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 4351054547 MI Primary

Addresses

Primary practice location

22151 Moross Rd Ste 214
Detroit, MI 48236-2151

Mailing address

22151 Moross Rd Ste 214
Detroit, MI 48236-2151
Phone (313) 343-4867

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250602003281 MI Order and Referring Only - General SurgeryPractitioner - General Surgery 7517476476

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4351054547MIMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1649064478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22151 MOROSS RD STE 214",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362151",
            "telephone_number": "313-343-4867",
            "fax_number": "313-343-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22151 MOROSS RD STE 214",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362151",
            "telephone_number": "313-343-4867",
            "fax_number": "313-343-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYOUB",
        "first_name": "YASMEEN",
        "middle_name": "IMAD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4351054547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.