Individual provider Active NPI

Abdirahman Abdirisak Ahmed, MD

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1972350502
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301514900 Issued in MI
Practice address
3031 W Grand Blvd Ste 600
Detroit, MI 48202-3014
Phone
(614) 695-1997
NPI assigned
May 1, 2024
Last updated
Jul 1, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 4301514900 MI Primary

Addresses

Primary practice location

3031 W Grand Blvd Ste 600
Detroit, MI 48202-3014

Mailing address

3031 W Grand Blvd Ste 600
Detroit, MI 48202-3014

Other practice location 1

18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone (313) 593-7000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aahmed3395382@epic00.corewelldirect.org

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
I20260519000646 MI Practitioner - Internal Medicine 2264932144

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

26901 Beaumont Blvd
Southfield, MI 48033-3849

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Detroit Wayne County Health Authority CurrentSince May 7, 2024 Accepting new patients

Locations

3031 W Grand Blvd
Ste 600
Detroit, MI 48202
Phone (313) 346-5235

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19827/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1714521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1972350502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 W GRAND BLVD STE 600",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 W GRAND BLVD STE 600",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023014",
            "telephone_number": "614-695-1997"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18101 Oakwood Blvd",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481244089",
            "country_code": "US",
            "telephone_number": "313-593-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHMED",
        "first_name": "ABDIRAHMAN",
        "middle_name": "ABDIRISAK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-01",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301514900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aahmed3395382@epic00.corewelldirect.org",
            "affiliation": "N",
            "address_1": "18101 Oakwood Blvd",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481244089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.