OLIVE TREE MEDICAL CLINIC PC
NPI 1457660789
Family Medicine in Dearborn, MI
About Olive Tree Medical Clinic Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
OLIVE TREE MEDICAL CLINIC PC (NPI 1457660789) is a healthcare organization registered as a family medicine in Dearborn, Michigan and active in the NPI registry since October 2010. The organization lists Sham Juratli, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Olive Tree Medical Clinic Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Olive Tree Medical Clinic PC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Olive Tree Medical Clinic PC's NPI number?
The NPI number for Olive Tree Medical Clinic PC is 1457660789. It was assigned to this organization in the NPPES registry on October 5, 2010.
Where is Olive Tree Medical Clinic PC located?
Olive Tree Medical Clinic PC is located at 18181 Oakwood Blvd Suite 206, Dearborn, MI 48124. The listed phone number is (313) 451-8253.
What is Olive Tree Medical Clinic PC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Olive Tree Medical Clinic PC enrolled in Medicare?
Yes. Olive Tree Medical Clinic PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Olive Tree Medical Clinic PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Olive Tree Medical Clinic PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Olive Tree Medical Clinic PC accept?
Health plans from Blue Cross Blue Shield of Michigan Mutual Insurance Company list Olive Tree Medical Clinic PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Olive Tree Medical Clinic PC was last updated on November 2, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Olive Tree Medical Clinic Pc · NPI 1457660789
Family Medicine organization in Dearborn, Michigan. Organization record, active in the CMS NPPES registry since October 5, 2010.
## Identity
- **NPI:** 1457660789 (Entity type: Organization)
- **Enumerated:** October 5, 2010
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Sham Juratli, PRESIDENT
## Practice location
- **Address:** 18181 OAKWOOD BLVD, SUITE 206, Dearborn, MI 48124-5032
- **Phone:** (313) 451-8253 · **Fax:** (313) 451-8351
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 2, 2016
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Source: [NPI Profile](https://npiprofile.com/npi/1457660789) · Data from the CMS NPPES public registry.