Individual provider Active NPI

Nissrin Rita Malouf, M.S.,PA-C

  • Medical Physician Assistant
  • Detroit, MI
National Provider Identifier
1801012463
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601004305 Issued in MI
Practice address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone
(313) 916-3364
NPI assigned
Apr 18, 2007
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601004305 MI
Medical Physician Assistant 363AM0700X 5601004305 MI Primary
Surgical Physician Assistant 363AS0400X 5601004305 MI

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202-2608

Mailing address

2107 Prescott Dr
Troy, MI 48083-2529
Phone (248) 790-3331

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041229000123 MI Practitioner - Physician Assistant 5991763534 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wayne State University School of Medicine, 2004
Medicare assignment
May accept Medicare assignment
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

1 Ford PL
Detroit, MI 48202-3067

1 Ford PL
Suite 2E
Detroit, MI 48202-3450

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

One Ford Place
2E
Detroit, MI 48202-3450

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601004305MIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Heath System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henr Y Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System Physician Assistant CurrentSince Oct 25, 2004 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henr Y Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System CurrentSince Oct 25, 2004 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients
Henry Ford Health System CurrentSince Jan 1, 1990 Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

Interoperability endpoints

  • FHIR API: https://fhir.hfhs.org/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: nmalouf15764@direct.hfhs.org

Organizations & group practices 31

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.

View all 31

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": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1801012463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2107 PRESCOTT DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480832529",
            "telephone_number": "248-790-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-3364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALOUF",
        "first_name": "NISSRIN",
        "middle_name": "RITA",
        "name_prefix": "Mrs.",
        "credential": "M.S.,PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004305",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601004305",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601004305",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.