Individual provider Active NPI

Masrura Quayoum

  • Family Nurse Practitioner
  • Dearborn, MI
National Provider Identifier
1922705664
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F11220869 Issued in MI
Practice address
7542 Wyoming St
Dearborn, MI 48126-1690
Phone
(313) 415-1515
NPI assigned
Feb 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F11220869 MI Primary

Addresses

Primary practice location

7542 Wyoming St
Dearborn, MI 48126-1690

Mailing address

56669 Scotland Blvd
Shelby Township, MI 48316-5037
Phone (313) 556-3197

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230303000437 MI Practitioner - Nurse Practitioner 2668845157 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F11220869MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Urgent Care PC CurrentSince Sep 8, 2023 Accepting new patients
Hometown Urgent Care of Michigan, PC CurrentSince Dec 11, 2023 Accepting new patients
Hometown Urgent Care of Michigan, P.C. Current Accepting new patients
Insight Urgent Care PC CurrentSince Sep 8, 2023 Accepting new patients
Pic Indiana PC CurrentSince May 1, 2025 Accepting new patients
Hometown Urgent Care of Michigan, P.C. CurrentSince Dec 11, 2023 Accepting new patients

Locations

1131 M 32 W
Alpena, MI 49707
Phone (989) 250-1925

25 Columbia Ave E
Battle Creek, MI 49015
Phone (269) 425-3017

4800 S Saginaw St
Flint, MI 48507
Phone (810) 275-9108

1634 Gull Rd
Kalamazoo, MI 49048
Phone (269) 903-2835

1261 N Telegraph Rd
Monroe, MI 48162
Phone (734) 265-9123

6012 S Westnedge Ave
Portage, MI 49002
Phone (269) 220-8950

Interoperability endpoints

  • Direct secure messaging: masrura.quayoum.1@26566.direct.athenahealth.com
  • Direct secure messaging: masrura.quayoum.1@28492.direct.athenahealth.com

Organizations & group practices 6

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": "1676246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1922705664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56669 SCOTLAND BLVD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483165037",
            "telephone_number": "313-556-3197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7542 WYOMING ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261690",
            "telephone_number": "313-415-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAYOUM",
        "first_name": "MASRURA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "F11220869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.