Organization Active NPI

Ghinwa Nakkash, MD PC

  • Internal Medicine Physician
  • Troy, MI
National Provider Identifier
1740406263
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301078882 Issued in MI
Legal business name
GHINWA NAKKASH, MD PC
Practice address
1899 E Wattles Rd
Troy, MI 48085-5082
Phone
(248) 526-9999
Fax
(248) 526-9089
NPI assigned
Apr 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

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

Authorized official

Name
Kristina Aziz
Title
Accounts
Phone
(248) 526-9999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 4301078882 MI Primary

Addresses

Primary practice location

1899 E Wattles Rd
Troy, MI 48085-5082

Mailing address

PO Box 279
Hazel Park, MI 48030-0279
Phone (248) 526-9999

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040216001225 MI Part B Supplier - Clinic/Group Practice 2466347836 Receives reassigned benefits from 1 practitioner
Practice locations: Troy, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D1018834Ghinwa Nakkash MD and Enas Nakkash, MD1899 E Wattles, Troy, MI 48085Certificate of waiverNov 2, 2027

National Provider Directory

National Provider Directory

Locations

1899 E Wattles Rd
Troy, MI 48085
Phone (248) 526-9999

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383523200000",
    "number": "1740406263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 279",
            "city": "HAZEL PARK",
            "state": "MI",
            "postal_code": "480300279",
            "telephone_number": "248-526-9999",
            "fax_number": "248-526-9089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1899 E WATTLES RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480855082",
            "telephone_number": "248-526-9999",
            "fax_number": "248-526-9089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GHINWA NAKKASH, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2013-11-04",
        "status": "A",
        "authorized_official_last_name": "AZIZ",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "ACCOUNTS",
        "authorized_official_telephone_number": "248-526-9999"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301078882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.