NPIMap

Individual provider Active NPI

Nabil Kamal Rizk, M.D.

  • Family Medicine Physician
  • Saint Clair Shores, MI
National Provider Identifier
1861493124
Registry record updated Dec 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301072314 Issued in MI
Practice address
21400 E 11 Mile Rd
St Clair Shores, MI 48081-1502
Phone
(586) 498-4400
Fax
(586) 498-4440
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301072314 MI Primary

Addresses

Primary practice location

21400 E 11 Mile Rd
St Clair Shores, MI 48081-1502

Mailing address

PO Box 77000
Detroit, MI 48277-2000
Phone (586) 447-4171

Other identifiers 1

IdentifierTypeStateIssuer
4392580MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080215000618 MI Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 3476636291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11270 E 13 Mile Rd
Suite 4
Warren, MI 48093-2599
Phone (586) 574-0630

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301072314MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Cornerstone Medical Group Family Medicine Current Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients
Henry Ford Health St. John Hospital Family Medicine CurrentSince Jul 1, 2017 Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Jul 1, 2017 Accepting new patients
St. John Hospital Past Accepting new patients

Locations

42645 Garfield Rd
Ste 103
Clinton Twp, MI 48038
Phone (586) 286-0050

46591 Romeo Plank Rd
Macomb, MI 48044
Phone (586) 226-6269

11270 E 13 Mile Rd
Ste 4
Warren, MI 48093
Phone (586) 574-0630

Interoperability endpoints

  • Direct secure messaging: nrizk1016604@direct.hfhs.org
  • FHIR API: https://fhir-myrecord.cerner.com/r4/mQjCqHb5rkr1u1foU4dqhQPBpi7Qk9R4/

Organizations & group practices 5

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 4

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323734400000",
    "number": "1861493124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 77000",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482772000",
            "telephone_number": "586-447-4171",
            "fax_number": "586-447-4180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21400 E 11 MILE RD",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811502",
            "telephone_number": "586-498-4400",
            "fax_number": "586-498-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIZK",
        "first_name": "NABIL",
        "middle_name": "KAMAL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2011-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301072314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4392580",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.