Active NPI
Elite Medical Group PC
- Internal Medicine Physician
- West Bloomfield, MI
National Provider Identifier
1801637293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- ELITE MEDICAL GROUP PC
- Practice address
- 3210 Pine Lake Rd
West Bloomfield, MI 48324-1951 - Phone
- (248) 974-2511
- NPI assigned
- Jun 1, 2024
- Last updated
- Jun 1, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Yousif Ishmail, MD
- Title
- Owner
- Phone
- (248) 974-2511
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
3210 Pine Lake Rd
West Bloomfield, MI 48324-1951
Mailing address
3210 Pine Lake Rd
West Bloomfield, MI 48324-1951
Phone (248) 974-2511
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
32000 Northwestern Hwy
Ste 120
Farmington Hills, MI 48334
Phone (248) 918-0800
32000 Northwestern Hwy
Ste 460
Farmington Hills, MI 48334
Practitioners & affiliated clinicians
Practitioners 11
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.
-
- Internal Medicine Physician
- Southfield, MI
- NPI 1225046220
-
- Internal Medicine Physician
- Southfield, MI
- NPI 1306078662
-
- Internal Medicine Physician
- Southfield, MI
- NPI 1164047932
-
- Internal Medicine Physician
- Troy, MI
- NPI 1184030942
-
- Internal Medicine Physician
- Southfield, MI
- NPI 1366510893
-
- Internal Medicine Physician
- Ypsilanti, MI
- NPI 1598007510
-
- Internal Medicine Physician
- Dearborn, MI
- NPI 1033101084
-
- Medical Physician Assistant
- Farmington Hills, MI
- NPI 1851186225
-
- Internal Medicine Physician
- Troy, MI
- NPI 1003170739
-
- Cardiovascular Disease Physician
- Southfield, MI
- NPI 1225011711
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717200000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1717200000000",
"number": "1801637293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3210 PINE LAKE RD",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483241951",
"telephone_number": "248-974-2511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3210 PINE LAKE RD",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483241951",
"telephone_number": "248-974-2511"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ELITE MEDICAL GROUP PC",
"organizational_subpart": "NO",
"enumeration_date": "2024-06-01",
"last_updated": "2024-06-01",
"certification_date": "2024-06-01",
"status": "A",
"authorized_official_last_name": "ISHMAIL",
"authorized_official_first_name": "YOUSIF",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "248-974-2511",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Bloomfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.