| Neuro Team One Pllc | |
|
31500 Telegraph Rd Ste 115 Bingham Farms MI 48025-4302 | |
| (248) 621-9100 | |
| Not Available |
| Full Name | Neuro Team One Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 31500 Telegraph Rd Ste 115, Bingham Farms, Michigan |
| Authorized Official Name and Position | Andrew Rathnasamy Xavier (MEMBER) |
| Authorized Official Contact | 2486219100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neuro Team One Pllc 6632 Telegraph Rd Ste 204 Bloomfield Hills MI 48301-3012 Ph: () - | Neuro Team One Pllc 31500 Telegraph Rd Ste 115 Bingham Farms MI 48025-4302 Ph: (248) 621-9100 |
| NPI Number | 1699227116 |
|---|---|
| Provider Enumeration Date | 11/01/2016 |
| Last Update Date | 07/08/2020 |
| Certification Date | 07/08/2020 |
| Medicare PECOS PAC ID | 0143596379 |
|---|---|
| Medicare Enrollment ID | O20171016002730 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699227116 | NPI | - | NPPES |
| 4950019 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 4301088851 (Michigan) | Primary |
| 2084V0102X | Psychiatry & Neurology - Vascular Neurology | 4301088851 (Michigan) | Secondary |
| Provider Name | Tracey A Haener |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295709103 PECOS PAC ID: 2264475573 Enrollment ID: I20050608000115 |
| Provider Name | Andrew Rathnasamy Xavier |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1124097225 PECOS PAC ID: 5597793695 Enrollment ID: I20070131000088 |
| Provider Name | Mahmoud Rayes |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942464961 PECOS PAC ID: 6507005428 Enrollment ID: I20130625000289 |
| Provider Name | Omran B Kaskar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629208798 PECOS PAC ID: 9436374378 Enrollment ID: I20140708002246 |
| Provider Name | Abhishek Singh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003044793 PECOS PAC ID: 1254642218 Enrollment ID: I20150617000408 |
| Provider Name | Sasha Ohlde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598141046 PECOS PAC ID: 3274809256 Enrollment ID: I20171018001890 |
| Provider Name | Tonya Lee Richards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376050096 PECOS PAC ID: 7618231689 Enrollment ID: I20180430001042 |
| Provider Name | Mouhammad Aghiad Jumaa |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1124287164 PECOS PAC ID: 9234280041 Enrollment ID: I20180719002162 |
| Provider Name | Arun K Sherma |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942474614 PECOS PAC ID: 1153616313 Enrollment ID: I20190215001826 |
| Provider Name | Hannah Elizabeth Olgren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801376116 PECOS PAC ID: 7719217231 Enrollment ID: I20190926001661 |
| Provider Name | Elzbieta Wisniewski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679134563 PECOS PAC ID: 3072942986 Enrollment ID: I20200327002451 |
| Provider Name | Syed Zaidi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619177748 PECOS PAC ID: 5698848273 Enrollment ID: I20200407000826 |
| Provider Name | Praveen Venkatachalam |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730588732 PECOS PAC ID: 1759695612 Enrollment ID: I20200501000485 |
| Provider Name | Mercedes Mcgaughey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841811825 PECOS PAC ID: 7315350709 Enrollment ID: I20210104000047 |
| Provider Name | Thirukandeeswaram Swaminathan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1811145527 PECOS PAC ID: 8820135478 Enrollment ID: I20210225002325 |
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