Organization Active NPI

Ishaqsei MD PLLC

  • Internal Medicine Physician
  • West Bloomfield, MI
National Provider Identifier
1659819639
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301080522 Issued in MI
Legal business name
ISHAQSEI MD PLLC
Practice address
7493 Kennington Blvd
West Bloomfield, MI 48322-3181
Phone
(248) 470-1325
NPI assigned
Feb 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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

Authorized official

Name
Dr. Wahed Ishaqsei, M.D.NPI 1063423176
Title
President
Phone
(248) 470-1325

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 4301080522 MI Primary

Addresses

Primary practice location

7493 Kennington Blvd
West Bloomfield, MI 48322-3181

Mailing address

7493 Kennington Blvd
West Bloomfield, MI 48322-3181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170220001951 MI Part B Supplier - Clinic/Group Practice 6901189869 Receives reassigned benefits from 4 practitioners
Practice locations: Grossepointe Woods, MI; Warren, MI; St Clair Shores, MI; Madison Heights, MI; Grosse Pointewoods, MI; Detroit, MI; Centerline, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486598400000",
    "number": "1659819639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7493 KENNINGTON BLVD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7493 KENNINGTON BLVD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223181",
            "telephone_number": "248-470-1325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISHAQSEI MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-09",
        "last_updated": "2017-02-09",
        "status": "A",
        "authorized_official_last_name": "ISHAQSEI",
        "authorized_official_first_name": "WAHED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-470-1325",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301080522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.