Individual provider Active NPI

Ayman Omar Soubani, MD

  • Pulmonary Disease Physician
  • Detroit, MI
National Provider Identifier
1861439358
Registry record updated Jun 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
4301075101 Issued in MI
Practice address
4100 John R St
Karmanos Cancer Center
Detroit, MI 48201-2013
Phone
(800) 527-6266
Fax
(313) 576-8381
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301075101 MI
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 4301075101 MI
Pulmonary Disease Physician 207RP1001X 4301075101 MI Primary

Addresses

Primary practice location

4100 John R St
Karmanos Cancer Center
Detroit, MI 48201-2013

Mailing address

1560 E. Maple Rd.
Suite 400-Credentialing
Troy, MI 48083-1135
Phone (800) 527-6266

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
I20060706000148 MI Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 0749292944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

4100 John R St
Detroit, MI 48201-2013
Phone (800) 527-6266

Hospital & facility affiliations

  • Karmanos Cancer Center Hospital, Detroit, MI, CCN 230297
  • Detroit Receiving Hospital Hospital, Detroit, MI, CCN 230273
  • Harper University Hospital Hospital, Detroit, MI, CCN 230104

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301075101MIMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Group Internal Medicine CurrentSince Oct 1, 2006 Accepting new patients
University Physician Group Past Accepting new patients
VHS Detroit Receiving Hospital Inc Past Accepting new patients
VHS Harper-Hutzel Hospital Inc Past Accepting new patients

Locations

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

1560 E Maple Rd
Ste 400
Troy, MI 48083

Interoperability endpoints

  • Direct secure messaging: ayman.soubani.1@19711.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467072000000",
    "number": "1861439358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E. MAPLE RD.",
            "address_2": "SUITE 400-CREDENTIALING",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831135",
            "telephone_number": "800-527-6266",
            "fax_number": "313-576-8381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 JOHN R ST",
            "address_2": "KARMANOS CANCER CENTER",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012013",
            "telephone_number": "800-527-6266",
            "fax_number": "313-576-8381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUBANI",
        "first_name": "AYMAN",
        "middle_name": "OMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2016-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301075101",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MI",
            "license": "4301075101",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "4301075101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.