Individual provider Active NPI

Madiha Salim, MD

  • Internal Medicine Physician
  • Walled Lake, MI
National Provider Identifier
1760845895
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301500348 Issued in MI
Practice address
620 N Pontiac TRL
Walled Lake, MI 48390-3448
Phone
(248) 624-4511
Fax
(248) 624-4408
NPI assigned
Apr 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 4301500348 MI
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 4301500348 MI Primary

Addresses

Primary practice location

620 N Pontiac TRL
Walled Lake, MI 48390-3448

Mailing address

1539 S Hill Blvd
Bloomfield Hills, MI 48304-1124
Phone (630) 247-3183

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
I20190830001632 MI Practitioner - Internal Medicine 0941590319 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
VMD Primary Providers Eastern Michigan PCGroup PAC ID 9234480575, 63 clinicians

Practice addresses (Care Compare)

620 N Pontiac TRL
Pontiac Trail Medical Center
Walled Lake, MI 48390-3448
Phone (248) 624-4511

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301500348MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Envision Medical Group PLLC CurrentSince Aug 1, 2020 Accepting new patients
VMD Primary Providers Eastern Michigan, PC Internal Medicine CurrentSince Sep 4, 2021 Accepting new patients
Envision Medical Group PLLC CurrentSince Aug 1, 2020 Accepting new patients

Locations

42931 7 Mile Rd
Northville, MI 48167
Phone (248) 348-2442

39475 Lewis Dr
Ste 130
Novi, MI 48377
Phone (248) 374-0502

620 N Pontiac Trl
Walled Lake, MI 48390
Phone (248) 624-4511

Interoperability endpoints

  • Direct secure messaging: madiha.salim.1@21803.direct.athenahealth.com
  • Direct secure messaging: msalim715719@direct.hfhs.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1760845895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1539 S HILL BLVD",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483041124",
            "telephone_number": "630-247-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N PONTIAC TRL",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903448",
            "telephone_number": "248-624-4511",
            "fax_number": "248-624-4408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALIM",
        "first_name": "MADIHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-05",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MI",
            "license": "4301500348",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301500348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walled Lake, MI

Sources for this page

Verify at the official NPI Registry.