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ELITE SPORTS & REGENERATIVE MEDICINE PLLC
NPI 1619863933
Family Medicine - Sports Medicine in Dearborn, MI

Active since June 13, 2025
1022 N TELEGRAPH RD STE 2, DEARBORN, MI 48128(313) 764-0088(313) 254-3586 Get Directions Write a Review

NPPES record last updated: June 13, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Elite Sports & Regenerative Medicine Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELITE SPORTS & REGENERATIVE MEDICINE PLLC (NPI 1619863933) is a healthcare organization registered as a sports medicine in Dearborn, Michigan and active in the NPI registry since June 2025. The organization lists Mohammad Ibrahim, Manager, as its authorized official.

NPPES Registry Identity

NPI1619863933
Entity TypeOrganization
Primary Taxonomy207QS0010X
Legal Business NameELITE SPORTS & REGENERATIVE MEDICINE PLLC
Location Address1022 N TELEGRAPH RD STE 2Dearborn, MI 48128-1622
Mailing Address1022 N Telegraph Rd Ste 2Dearborn, MI 48128-1622 · (313) 764-0088 · Fax (313) 254-3586
Phone(313) 764-0088
Fax(313) 254-3586
Organization SubpartNo
Authorized OfficialMohammad IbrahimManager · (313) 764-0088
Enumeration DateJune 13, 2025
NPPES CertifiedJune 13, 2025
✔ NPI 1619863933 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
Definition
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
1022 N TELEGRAPH RD STE 2, Dearborn, MI 48128
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Other Names 1

Other NameElite Sports & Regenerative Medicine

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company.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)

Elite Sports & Regenerative Medicine Pllc 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 Elite Sports & Regenerative Medicine PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Mohammad Ibrahim, DO
Sports Medicine
NPI 1962024968
1022 N TELEGRAPH RD STE 2
Dearborn, MI 48128
(313) 764-0088
✔ PECOS✔ Accepts MedicareSame address

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 Elite Sports & Regenerative Medicine PLLC's NPI number?

The NPI number for Elite Sports & Regenerative Medicine PLLC is 1619863933. It was assigned to this organization in the NPPES registry on June 13, 2025. The provider is also known as Elite Sports & Regenerative Medicine.

Where is Elite Sports & Regenerative Medicine PLLC located?

Elite Sports & Regenerative Medicine PLLC is located at 1022 N Telegraph Rd Ste 2, Dearborn, MI 48128. The listed phone number is (313) 764-0088.

What is Elite Sports & Regenerative Medicine PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Elite Sports & Regenerative Medicine PLLC enrolled in Medicare?

Yes. Elite Sports & Regenerative Medicine PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Elite Sports & Regenerative Medicine PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Sports Medicine) reassigns their Medicare billing to Elite Sports & Regenerative Medicine PLLC. 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 Elite Sports & Regenerative Medicine PLLC accept?

Health plans from Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Elite Sports & Regenerative Medicine PLLC 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 Elite Sports & Regenerative Medicine PLLC was last updated on June 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.