Individual provider Active NPI

Ali H Fakih, O.D.

  • Optometrist
  • Allen Park, MI
National Provider Identifier
1881602704
Registry record updated Oct 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901004300 Issued in MI
Practice address
14726 Champaign Rd
Allen Park, MI 48101-1617
Phone
(313) 707-6667
NPI assigned
Aug 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901004300 MI Primary

Addresses

Primary practice location

14726 Champaign Rd
Allen Park, MI 48101-1617

Mailing address

14726 Champaign Rd
Allen Park, MI 48101-1617
Phone (313) 707-6667

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
I20060223000668 MI Practitioner - Optometry 6901812221 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

26629 Hopkins St
Inskter, MI 48141-3111
Phone (313) 278-5141

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Eye Clinic PC Optometrist CurrentSince Apr 25, 2012 Accepting new patients

Locations

14726 Champaign Rd
Allen Park, MI 48101
Phone (313) 707-6667

26629 Hopkins St
Inkster, MI 48141
Phone (313) 278-5141

Interoperability endpoints

  • Direct secure messaging: michiganeyeclinic.alifakih@131818.advancedmd-direct.com

Organizations & group practices 1

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476403200000",
    "number": "1881602704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14726 CHAMPAIGN RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481011617",
            "telephone_number": "313-707-6667",
            "fax_number": "313-789-5478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14726 CHAMPAIGN RD",
            "city": "ALLEN PARK",
            "state": "MI",
            "postal_code": "481011617",
            "telephone_number": "313-707-6667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKIH",
        "first_name": "ALI",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2016-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allen Park, MI

Sources for this page

Verify at the official NPI Registry.