Organization Active NPI

Aneela Yaqoob MD PLLC

  • Infectious Disease Physician
  • Wayne, MI
National Provider Identifier
1831414622
Registry record updated Apr 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
4301075063 Issued in MI
Legal business name
ANEELA YAQOOB MD PLLC
Practice address
33155 Annapolis St
Wayne, MI 48184-2405
Phone
(734) 981-5250
NPI assigned
Apr 5, 2010
Last updated
Apr 5, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2010

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

Authorized official

Name
Dr. Aneela Yaqoob, MDNPI 1104099266
Title
President
Phone
(734) 981-5250

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 4301075063 MI Primary

Addresses

Primary practice location

33155 Annapolis St
Wayne, MI 48184-2405

Mailing address

3515 Parklawn Dr
Canton, MI 48188-2315
Phone (734) 981-5250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100715000748 MI Part B Supplier - Clinic/Group Practice 3375675085 Receives reassigned benefits from 1 practitioner
Practice locations: Taylor, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270425600000",
    "number": "1831414622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 PARKLAWN DR",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882315",
            "telephone_number": "734-981-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33155 ANNAPOLIS ST",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481842405",
            "telephone_number": "734-981-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANEELA YAQOOB MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-05",
        "last_updated": "2010-04-05",
        "status": "A",
        "authorized_official_last_name": "YAQOOB",
        "authorized_official_first_name": "ANEELA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-981-5250",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "MI",
            "license": "4301075063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2010; 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.

Verify at the official NPI Registry.