A Comprehensive Dermatology Center

Primary specialty

SpecialistTaxonomy code 174400000X

License

AM059655 Issued in MI

Legal business name

A COMPREHENSIVE DERMATOLOGY CENTER

Practice address

1575 W Big Beaver Rd
Ste C12
Troy, MI 48084-3536

Phone

(248) 643-7677

Fax

(248) 643-7679

NPI assigned

Jun 15, 2009

Last updated

Nov 6, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ali Moiin, M.D.NPI 1255313979

Title

Physician

Phone

(248) 643-7677

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 5

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.

• Ali Moiin, MD

  • Dermatology Physician
  • Troy, MI
  • NPI 1255313979
  Medicare reassignment Care Compare group NPD Authorized official
• Brett Michael Hresko, DO

  • Student in an Organized Health Care Education/Training Program
  • Detroit, MI
  • NPI 1447980917
  Medicare reassignment Care Compare group NPD
• Peter Jajou, D.O.

  • Dermatology Physician
  • Roseville, MI
  • NPI 1609296144
  Medicare reassignment NPD
• Mohammad Zarka, D.O.

  • Dermatology Physician
  • Lapeer, MI
  • NPI 1144459942
  Medicare reassignment NPD
• Jincy Mathew, PA-C

  • Physician Assistant
  • Detroit, MI
  • NPI 1093953648
  Medicare reassignment

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

{
    "created_epoch": "1245024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415232000000",
    "number": "1750518031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 W BIG BEAVER RD",
            "address_2": "STE C12",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843536",
            "telephone_number": "248-643-7677",
            "fax_number": "248-643-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 W BIG BEAVER RD",
            "address_2": "STE C12",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843536",
            "telephone_number": "248-643-7677",
            "fax_number": "248-643-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A COMPREHENSIVE DERMATOLOGY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-15",
        "last_updated": "2014-11-06",
        "status": "A",
        "authorized_official_last_name": "MOIIN",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "248-643-7677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MI",
            "license": "AM059655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4251045-10",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 3 Doves Home Assistance
• 3-D Maxillofacial Imaging Centers, PLC
• 365 Health Care Group PLC
• 617 Healhy Living LLC
• A Choice Home Health Care, Inc.
• Sophia A Garvin
• A Glenn Snyder MD MPH PLLC
• Mary A Pogasic, BSN, RN
• Aaa Best Home Health Solutions LLC
• Aairs Diagnostics PC

• Specialist in Troy, MI
• Providers in Troy, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; 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.