Individual provider Active NPI

Adib Abdelrahman, D.O.

  • Obstetrics & Gynecology Physician
  • Pontiac, MI
National Provider Identifier
1679889406
Registry record updated Aug 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
L1812709 Issued in MI
Practice address
44405 Woodward Ave
Pontiac, MI 48341-5023
Phone
(248) 858-3231
NPI assigned
Aug 31, 2010
Last updated
Aug 31, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X L1812709 MI Primary

Addresses

Primary practice location

44405 Woodward Ave
Pontiac, MI 48341-5023

Mailing address

4184 Colorado LN
West Bloomfield, MI 48322-4421

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
I20180213002555 MI Practitioner - Obstetrics/Gynecology 6901191253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SJMH Medical Practice-SMHCGroup PAC ID 8628965175, 27 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.43 of 100Reported as group
Quality
84.93
Improvement activities
0
Cost
73.5

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
L1812709MIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SJMH Medical Practice-SMHC Obstetrics & Gynecology CurrentSince Jan 19, 2018 Accepting new patients
SJMH Medical Practice-SMHC CurrentSince Jan 19, 2018 Accepting new patients

Locations

44405 Woodward Ave
Pontiac, MI 48341
Phone (248) 858-3023

44428 Woodward Ave
Ste 101
Pontiac, MI 48341

Interoperability endpoints

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283212800000",
    "number": "1679889406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4184 COLORADO LN",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44405 WOODWARD AVE",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415023",
            "telephone_number": "248-858-3231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDELRAHMAN",
        "first_name": "ADIB",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-31",
        "last_updated": "2010-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "L1812709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.