NPIMap

Individual provider Active NPI

Nooreldin Elkosh, MD

  • Family Medicine Physician
  • Dearborn, MI
National Provider Identifier
1891356036
Registry record updated Jul 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301505320 Issued in MI
Practice address
17000 Hubbard Dr
Dearborn, MI 48126-4258
Phone
(313) 982-4351
Fax
(313) 982-4370
NPI assigned
Jun 27, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301505320 MI Primary
Family Medicine Physician 207Q00000X 4351044827 MI

Addresses

Primary practice location

17000 Hubbard Dr
Dearborn, MI 48126-4258

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849

Other practice location 1

G3230 Beecher Rd Ste 1
Flint, MI 48532-3604
Phone (810) 342-5656

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nelkosh4117629@direct.beaumont.edu

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
I20220712001505 MI Practitioner - Family Practice 9931435112 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oakwood Ambulatory LLCGroup PAC ID 1850282914, 271 clinicians

Practice addresses (Care Compare)

17000 Hubbard Dr
Dearborn, MI 48126-4258
Phone (313) 982-4351

201 3Rd St
Suite 200
Belleville, MI 48111-2605
Phone (734) 697-9065

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oakwood Ambulatory, LLC CurrentSince Jul 8, 2022 Accepting new patients
Oakwood Ambulatory LLC Family Medicine CurrentSince Jul 8, 2022 Accepting new patients

Locations

201 3rd St
Ste 200
Belleville, MI 48111
Phone (734) 697-9065

17000 Hubbard Dr
Ste 800
Dearborn, MI 48126
Phone (313) 240-7595

17000 Hubbard Dr
Dearborn, MI 48126
Phone (313) 271-3802

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

Interoperability endpoints

  • Direct secure messaging: nooreldin.elkosh.1@30520.direct.athenahealth.com
  • Direct secure messaging: nelkosh4117629@direct.beaumont.edu
  • Direct secure messaging: nelkosh1232557@epic00.shdirect.org

Organizations & group practices 2

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657238400000",
    "number": "1891356036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17000 HUBBARD DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481264258",
            "telephone_number": "313-982-4351",
            "fax_number": "313-982-4370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "G3230 Beecher Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485323604",
            "country_code": "US",
            "telephone_number": "810-342-5656",
            "fax_number": "810-342-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELKOSH",
        "first_name": "NOORELDIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-27",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301505320",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4351044827",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nelkosh4117629@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "17000 Hubbard Dr",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481264258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.