Individual provider Active NPI

Abdullah Nabil Hizam, OTR

  • Occupational Therapist
  • Southfield, MI
National Provider Identifier
1679227995
Registry record updated Feb 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201012743 Issued in MI
Practice address
26645 W 12 Mile Rd Ste 201
Southfield, MI 48034-7812
Phone
(248) 223-4430
NPI assigned
Feb 6, 2022
Last updated
Feb 6, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201012743 MI Primary

Addresses

Primary practice location

26645 W 12 Mile Rd Ste 201
Southfield, MI 48034-7812

Mailing address

26645 W 12 Mile Rd Ste 201
Southfield, MI 48034-7812
Phone (248) 223-4430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5201012743MIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Safe Hands Home Health Care, LLC PastSince Feb 13, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1644105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644105600000",
    "number": "1679227995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26645 W 12 MILE RD STE 201",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480347812",
            "telephone_number": "248-223-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26645 W 12 MILE RD STE 201",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480347812",
            "telephone_number": "248-223-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIZAM",
        "first_name": "ABDULLAH",
        "middle_name": "NABIL",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-06",
        "last_updated": "2022-02-06",
        "certification_date": "2022-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201012743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.