Mariam Abdul-Hussein Abbas

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

4704286635 Issued in MI

Practice address

14799 Dix Toledo Rd
Southgate, MI 48195-2507

Phone

(734) 324-8326

NPI assigned

Mar 10, 2022

Last updated

Mar 10, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Vitality Health Clinic PLLCGroup PAC ID 7911345103, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Vitality Health Clinic PLLC

  • Family Medicine Physician
  • Dearborn Heights, MI
  • NPI 1689430407
  Medicare reassignment Care Compare group NPD
• Team Wellness Center

  • Community Health Clinic/Center
  • Detroit, MI
  • NPI 1588855100
  Medicare reassignment NPD
• Vitality Health Clinic

  • Clinic/Center
  • Dearborn Heights, MI
  • NPI 1760248587
  NPD Authorized official
• Team Mental Health Services Inc.

  dba Team Wellness Center

  • Primary Care Clinic/Center
  • Detroit, MI
  • NPI 1295324291
  NPD

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

{
    "created_epoch": "1646870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646870400000",
    "number": "1982352811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 DOVER ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481274114",
            "telephone_number": "313-671-8961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14799 DIX TOLEDO RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952507",
            "telephone_number": "734-324-8326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABBAS",
        "first_name": "MARIAM",
        "middle_name": "ABDUL-HUSSEIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-10",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704286635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• -
• 20 20 Contacts - Eyeglasses Inc.
• A.M. Mussani, MD., P.C.
• Ali Hussein Abdallah, DMD
• Nasri Abdelnour
• Ali Abdul-Hadi, PHARMD
• Amal Mohamed Ali Abdul-Hussein
• Husam Abed, MD

• Gerontology Nurse Practitioner in Southgate, MI
• Providers in Southgate, MI by specialty
• Gerontology Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.