Active NPI
Ibrahim Youssef, MD
- Psychiatry Physician
- Westland, MI
National Provider Identifier
1801816855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 4301046628
- Practice address
- 30901 Palmer Rd
Westland, MI 48186-9529 - Phone
- (734) 367-8403
- Fax
- (734) 722-9524
- NPI assigned
- Jul 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 4301046628 | MI | Primary |
Addresses
Primary practice location
30901 Palmer Rd
Westland, MI 48186-9529
Mailing address
45021 Governor Bradford Rd
Plymouth, MI 48170-3713
Phone (313) 451-1497
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508883299 | Other | MI | WRPH |
| 260Q26259 | Other | MI | BCBSM GR# |
| 4867235 | Medicaid | MI | |
| IY046628 | Other | MI | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301046628 | MI | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hegira Health, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Primary Care Clinic/Center
- Westland, MI
- NPI 1477141356
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1801816855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45021 GOVERNOR BRADFORD RD",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481703713",
"telephone_number": "313-451-1497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30901 PALMER RD",
"city": "WESTLAND",
"state": "MI",
"postal_code": "481869529",
"telephone_number": "734-367-8403",
"fax_number": "734-722-9524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUSSEF",
"first_name": "IBRAHIM",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-20",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "4301046628",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WRPH",
"identifier": "1508883299",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM GR#",
"identifier": "260Q26259",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4867235",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "IY046628",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Westland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.