Individual provider Active NPI

Enas Nakkash, MD,PC

  • Internal Medicine Physician
  • Troy, MI
National Provider Identifier
1801962691
Registry record updated Dec 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301077105 Issued in MI
Practice address
1899 E Wattles Rd
Troy, MI 48085-5082
Phone
(248) 526-9999
Fax
(248) 526-9089
NPI assigned
Nov 26, 2006
Last updated
Dec 30, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301077105 MI Primary

Addresses

Primary practice location

1899 E Wattles Rd
Troy, MI 48085-5082

Mailing address

PO Box 279
22039 Johnr Rd
Hazel Park, MI 48030-0279

Other identifiers 1

IdentifierTypeStateIssuer
4724250MedicaidMI

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
I20050601000463 MI Practitioner - Internal Medicine 6406898691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1899 E Wattles Rd
Troy, MI 48085-5082
Phone (248) 526-9999

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Enas Nakkash, MD PC Single Specialty CurrentSince Jun 29, 2007 Accepting new patients
Ghinwa Nakkash, MD PC Single Specialty PastSince Jun 1, 2004 Accepting new patients

Locations

5432 15 Mile Rd
Sterling Heights, MI 48310
Phone (586) 939-8888

1899 E Wattles Rd
Troy, MI 48085
Phone (248) 526-9999

Interoperability endpoints

  • Direct secure messaging: enakkash1142660@direct.hfhs.org
  • Direct secure messaging: enakkash1248421@epic00.shdirect.org

Organizations & group practices 2

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 5

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": "1164499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388361600000",
    "number": "1801962691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 279",
            "address_2": "22039 JOHNR RD",
            "city": "HAZEL PARK",
            "state": "MI",
            "postal_code": "480300279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1899 E WATTLES RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480855082",
            "telephone_number": "248-526-9999",
            "fax_number": "248-526-9089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKKASH",
        "first_name": "ENAS",
        "credential": "MD,PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-26",
        "last_updated": "2013-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301077105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4724250",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.