Mohammad Mustaquim

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

5601003917 Issued in MI

Practice address

6777 W Maple Rd
West Bloomfield, MI 48322-3013

Phone

(248) 661-6417

Fax

(248) 661-7390

NPI assigned

Jun 29, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Henry Ford Health West Bloomfield Hospital Hospital, W Bloomfield, MI, CCN 230302
• Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
• Wyandotte Hospital and Medical Center Hospital, Wyandotte, MI, CCN 230146

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmustaquim15945@direct.hfhs.org

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.

• Henry Ford Health System

  • Physician Assistant
  • Detroit, MI
  • NPI 1811073901
  Medicare reassignment Care Compare group NPD
• Henry Ford Health System

  • Community/Retail Pharmacy
  • Plymouth, MI
  • NPI 1942931720
  NPD
• Henry Ford Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Detroit, MI
  • NPI 1851410005
  NPD
• Henry Ford Maplegrove Center

  • Children's Substance Abuse Rehabilitation Facility
  • West Bloomfield, MI
  • NPI 1295767630
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Care Compare affiliation
• Henry Ford Health System

  • General Acute Care Hospital
  • West Bloomfield, MI
  • NPI 1407867559
  Care Compare affiliation
• Henry Ford Wyandotte Hospital

  • Ambulatory Surgical Clinic/Center
  • Wyandotte, MI
  • NPI 1093901035

  Hospital

  Care Compare affiliation
• Henry Ford Wyandotte Hospital

  • General Acute Care Hospital
  • Wyandotte, MI
  • NPI 1992725352
  Care Compare affiliation

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277769600000",
    "number": "1659682292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 HADSELL DR",
            "city": "BLOOMFIELD TOWNSHIP",
            "state": "MI",
            "postal_code": "483020408",
            "telephone_number": "248-943-6895",
            "fax_number": "248-661-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6777 W MAPLE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223013",
            "telephone_number": "248-661-6417",
            "fax_number": "248-661-7390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSTAQUIM",
        "first_name": "MOHAMMAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-29",
        "last_updated": "2010-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601003917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avery Jay Murav, DDS
• Katharine Murphy-Brown, DMD
• Brian Cleland Murphy, DDS
• Erin Dale Murria, MA, LLPC, CAC-R
• Nithila Murugan
• Sarah Mutch, LLMSW
• MVC Clinical Practice - Mi PC
• My Family Home Care
• Rebecca Myszenski, PT
• Reganne Nabozny

• Surgical Physician Assistant in West Bloomfield, MI
• Providers in West Bloomfield, MI by specialty
• Surgical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2010; 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.
• 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.