Adib Abdelrahman – Obstetrics & Gynecology Physician

Key facts

NPI: 1679889406
Entity type: Individual (NPI type 1)
Primary specialty: Obstetrics & Gynecology Physician 207V00000X
License: L1812709 (MI)
Practice address: 44405 Woodward Ave
Pontiac, MI 48341-5023
Phone: (248) 858-3231
NPI assigned: Aug 31, 2010
Sex: Male
Sole proprietor: No

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.

SJMH Medical Practice-SMHC Internal Medicine Physician · Pontiac, MI · NPI 1346284684

Medicare reassignment Care Compare group NPD MI · OBSTETRICS & GYNECOLOGY
SJMH Medical Practice-SMHC Urgent Care Clinic/Center · Waterford, MI · NPI 1366644551

NPD

Hospital & facility affiliations 1

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

St Joseph Mercy Hospital-SMHC General Acute Care Hospital · Pontiac, MI · NPI 1053356352

Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty: Obstetrics/Gynecology
Education: Other, 2010
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: SJMH Medical Practice-SMHC (27 clinicians)

Practice addresses (Care Compare)

44405 Woodward Ave
Pontiac, MI 48341-5023
Phone (248) 858-6101

Hospital & facility affiliations

Trinity Health Oakland Hospital Hospital · Pontiac, MI · CCN 230029

Merit-based Incentive Payment System (MIPS)

Final score: 76.43 of 100 (group)
Quality: 84.93
Improvement activities: 0
Cost: 73.5

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MI
Eligible to order & refer: Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20180213002555	MI	Practitioner - Obstetrics/Gynecology	6901191253	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Osteopathy

State licenses

License	State	Type	Specialty
L1812709	MI	MD	Obstetrics & Gynecology Physician

Practice roles

Organization	Specialty	Status	New patients
SJMH Medical Practice-SMHC		Current since Jan 19, 2018	Accepting new patients
SJMH Medical Practice-SMHC	Obstetrics & Gynecology	Current since Jan 19, 2018	Accepting new patients

Locations

44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3000

44428 Woodward Ave
Ste 101
Pontiac, MI 48341

Interoperability endpoints

Direct secure messaging: aabdelrahman36957@direct.trinity-health.org

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Obstetrics & Gynecology Physician	207V00000X	L1812709	MI	Yes

Addresses

Primary practice location

44405 Woodward Ave
Pontiac, MI 48341-5023

Mailing address

4184 Colorado LN
West Bloomfield, MI 48322-4421

Other providers in Pontiac, MI

All providers in Pontiac, MI · Obstetrics & Gynecology Physician in Michigan

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2010. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Order and Referring (CMS).
Medicare Care Compare provider data (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.