Individual provider Active NPI

Ali H. Nasrallah, OD

  • Optometrist
  • Dearborn, MI
National Provider Identifier
1811509649
Registry record updated Aug 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
00000000 Issued in MI
Practice address
5250 Auto Club Dr
Dearborn, MI 48126-2619
Phone
(313) 581-3888
NPI assigned
Aug 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 00000000 MI Primary

Addresses

Primary practice location

5250 Auto Club Dr
Dearborn, MI 48126-2619

Mailing address

5250 Auto Club Dr
Dearborn, MI 48126-2619

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Youreyesdr@gmail.com

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210120002442 MI Practitioner - Optometry 7719391432 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22361 W Village Dr
Suite 106
Dearborn, MI 48124-2227
Phone (313) 900-0090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00000000MIMDCommunity Health Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Alzohaili Medical Consultants MD PC CurrentSince Dec 15, 2020 Accepting new patients
Premier Eye Center PLLC Optometrist CurrentSince Dec 19, 2022 Accepting new patients

Locations

5250 Auto Club Dr
Ste 200
Dearborn, MI 48126
Phone (313) 203-5300

22720 Michigan Ave
Ste 200
Dearborn, MI 48124
Phone (313) 791-3000

5220 Oakman Blvd
Dearborn, MI 48126
Phone (313) 203-5300

22361 W Village Dr
Ste 106
Dearborn, MI 48124
Phone (313) 244-4444

4160 John R St
Ste 510
Detroit, MI 48201
Phone (313) 993-7777

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IGJJCD/Endpoint/IGJJCD

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1597968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1811509649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5250 AUTO CLUB DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 AUTO CLUB DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262619",
            "telephone_number": "313-581-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASRALLAH",
        "first_name": "ALI",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-21",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "00000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Youreyesdr@gmail.com",
            "affiliation": "N",
            "address_1": "5250 Auto Club Dr",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481262619",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.