Individual provider Active NPI

Maram Attiq

  • Anesthesiology Physician
  • Detroit, MI
National Provider Identifier
1790104792
Registry record updated May 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
4301105714 Issued in MI
Practice address
3990 John R St # 162
Detroit, MI 48201-2018
Phone
(313) 745-7233
NPI assigned
Apr 8, 2014
Last updated
May 8, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MI
Anesthesiology Physician 207L00000X 4301105714 MI Primary

Addresses

Primary practice location

3990 John R St # 162
Detroit, MI 48201-2018

Mailing address

6597 Whispering Woods Dr
West Bloomfield, MI 48322-5201

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
I20170727001079 MI Practitioner - Anesthesiology 5496056582 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Beaumont Medical Group Hospital Based ServicesGroup PAC ID 3072875889, 575 clinicians
Northstar Anesthesia of Michigan III PLLCGroup PAC ID 7911325469, 561 clinicians

Practice addresses (Care Compare)

18101 Oakwood Blvd
Dearborn, MI 48124-4089

44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-1187

44201 Dequindre Rd Ec
Beaumont Emergency Services TR
Troy, MI 48085-1117
Phone (248) 964-5111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301105714MIMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Health Saint Mary's Medical Group CurrentSince Nov 1, 2022 Accepting new patients
Oakwood Ambulatory LLC CurrentSince Jul 10, 2017 Accepting new patients
Oakwood Ambulatory, LLC CurrentSince Jul 10, 2017 Accepting new patients
Advantage Health/Saint Mary's Medical Group Current Accepting new patients
Beaumont Medical Group Hospital -Based Services CurrentSince Aug 30, 2018 Accepting new patients
Northstar Anesthesia of Michigan PLLC Anesthesiology CurrentSince Nov 1, 2020 Accepting new patients
Advantage Health Saint Mary's Medical Group CurrentSince Nov 1, 2022 Accepting new patients
Northstar Anesthesia of Michigan III PLLC CurrentSince Aug 20, 2020 Accepting new patients
Detroit Medical Center Past Accepting new patients

Locations

201 3rd St
Ste 200
Belleville, MI 48111
Phone (734) 697-9065

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

3990 John R St
#162
Detroit, MI 48201
Phone (313) 745-7233

4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615

220 Cherry St SE
Grand Rapids, MI 49503
Phone (616) 685-5576

10000 Telegraph Rd
Taylor, MI 48180
Phone (313) 295-5000

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4000

Interoperability endpoints

  • Direct secure messaging: mattiq683868@direct.trinity-health.org
  • Direct secure messaging: mmarouki@direct.dmc.org

Organizations & group practices 9

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 3

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": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588896000000",
    "number": "1790104792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6597 WHISPERING WOODS DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483225201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 JOHN R ST # 162",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012018",
            "telephone_number": "313-745-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATTIQ",
        "first_name": "MARAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-08",
        "last_updated": "2020-05-08",
        "certification_date": "2020-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301105714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.