DR. ABDAL-RAHMAN IBRAHIM EL-MALLAH (MD) – Family Medicine Physician, NPI 1750956652

DR. ABDAL-RAHMAN IBRAHIM EL-MALLAH (MD) is a healthcare provider. based in Southfield, Michigan. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 4351048550 (MI). The NPI Number for DR. ABDAL-RAHMAN IBRAHIM EL-MALLAH (MD) is 1750956652

Main info

Male
6 Years Of Experience
Name
DR. ABDAL-RAHMAN IBRAHIM EL-MALLAH (MD)
NPI
1750956652
Phone
(248) 849-3447
Address
22250 Providence Drive
Enumeration Date
24 May 2021
Last Update Date
10 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3135952000
Graduation Year
2020 (6 years ago)
PAC ID
7517360258
Group Practice PAC ID
7012362833
Professional Enrollment ID
I20250428003946
Address ID
MI481272143DE24950STXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:5State licenses:1Digital endpointsOther names

4,418 FAMILY PRACTICE in MI

Provider Addresses for DR. ABDAL-RAHMAN IBRAHIM EL-MALLAH (MD)

  • 22250 Providence Drive

    Suite #557

    Southfield, MI 480754818

    Phone: (248) 849-3447

    Fax: (248) 849-8021

    Type: Location

  • 12700 S MORROW CIR

    DEARBORN, MI 481261552

    Phone: (313) 623-4910

    Type: Mailing

  • 22250 PROVIDENCE DRIVE

    SUITE #557

    SOUTHFIELD, MI 480754818

    Phone: (248) 849-3447

    Fax: (248) 849-8021

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-04-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250428003946IFamily PracticeMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48075)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7012362833View full group profile
NameSpecialtyState
Nurse PractitionerMI
Nurse PractitionerMI
Nurse PractitionerMI
Nurse PractitionerMI
Nurse PractitionerMI
Nurse PractitionerMI
Nurse PractitionerMI
Family PracticeMI
Physician AssistantMI

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Is there an official ID for DR. ABDAL-RAHMAN IBRAHIM EL-MALLAH (MD) in U.S. healthcare records?
The official identifier for DR. ABDAL-RAHMAN IBRAHIM EL-MALLAH (MD) is NPI 1750956652.
Would DR. ABDAL-RAHMAN IBRAHIM EL-MALLAH (MD) appear as active to a payer?
You can treat DR. ABDAL-RAHMAN IBRAHIM EL-MALLAH (MD) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe DR. ABDAL-RAHMAN IBRAHIM EL-MALLAH (MD)'s focus?
For DR. ABDAL-RAHMAN IBRAHIM EL-MALLAH (MD), the primary taxonomy reads as Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is DR. ABDAL-RAHMAN IBRAHIM EL-MALLAH (MD) associated with Southfield?
Public fields place DR. ABDAL-RAHMAN IBRAHIM EL-MALLAH (MD) around Southfield, Michigan. Always confirm the exact site before visiting.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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