Fares N Mubarez, AGACNP-BC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

4704298299 Issued in MI

Practice address

11800 E 12 Mile Rd
Warren, MI 48093-3472

Phone

(586) 573-5000

NPI assigned

Apr 29, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Complexcare Medical Group Midwest H PLLCGroup PAC ID 0143737148, 128 clinicians

Theoria MedicalGroup PAC ID 5395098339, 317 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fmubarez727710@direct.hfhs.org

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.

• Complexcare Medical Group Midwest H PLLC

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1457144933
  Medicare reassignment Care Compare group NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375
  Medicare reassignment Care Compare group
• Elite Prime Care PLLC

  • Internal Medicine Physician
  • Canton, MI
  • NPI 1104542828
  Medicare reassignment NPD
• Mdslivenow PLLC

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1215688965
  Medicare reassignment NPD
• Michigan Family Medicine and Urgent Care

  • Family Medicine Physician
  • Dewitt, MI
  • NPI 1497225403
  Medicare reassignment NPD
• Michigan Infectious Disease Associates, PC

  • Infectious Disease Physician
  • Warren, MI
  • NPI 1336346030
  Medicare reassignment NPD
• Detroit Medical Consultants PC

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1609229848
  Medicare reassignment
• Michigan Hospitalists Associates PC

  • Internal Medicine Physician
  • Canton, MI
  • NPI 1043029143
  NPD (past)

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

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1831753466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3970 TROWBRIDGE ST",
            "city": "HAMTRAMCK",
            "state": "MI",
            "postal_code": "482124103",
            "telephone_number": "313-384-6943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480933472",
            "telephone_number": "586-573-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUBAREZ",
        "first_name": "FARES",
        "middle_name": "N",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-29",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704298299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MICHIGAN STATE BOARD OF NURSING",
            "identifier": "4704298299",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bana Moureiden, DMD
• Fadi Mousa-Aqrawi, DDS
• Move on Physical Therapy
• Emily Moyers
• Mso Physicians
• David Cole Mueller, DO
• Sarah B Muenk-Gold, M.D.
• Donald B Muenk, M.D.
• Elizabeth Ann Muenk, M.A., L.L.P.
• Raghu Mulpuri, M.D.

• Gerontology Nurse Practitioner in Warren, MI
• Providers in Warren, MI by specialty
• Gerontology Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.