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DR. MOHAMMAD MAHMOUD IBRAHIM SAMARA MD
NPI 1679145460
Student in an Organized Health Care Education/Training Program in Detroit, MI

Active since July 12, 2021PECOS Enrolled
2799 W GRAND BLVD # 517, DETROIT, MI 48202(313) 916-7134 Get Directions Write a Review

NPPES record last updated: June 27, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 27, 2025, Aug 7, 2024, Jul 12, 2021 (3 updates tracked since 2021).

About Dr. Mohammad Mahmoud Ibrahim Samara Md NPPES

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

DR. MOHAMMAD MAHMOUD IBRAHIM SAMARA MD (NPI 1679145460) is an individual student in an organized health care education/training program in Detroit, Michigan and active in the NPI registry since July 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679145460
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDR. MOHAMMAD MAHMOUD IBRAHIM SAMARACredential: MD
Location Address2799 W GRAND BLVD # 517Detroit, MI 48202-2689
Mailing Address2799 W Grand Blvd # 517Detroit, MI 48202-2689 · (313) 916-7134
Phone(313) 916-7134
Sole ProprietorYes
Enumeration DateJuly 12, 2021
Last NPPES UpdateJune 27, 20253 updates tracked since enumeration
NPPES CertifiedJune 27, 2025
✔ NPI 1679145460 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2799 W GRAND BLVD # 517, Detroit, MI 48202
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mohammad Mahmoud Ibrahim Samara Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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 Mohammad Samara's NPI number?

The NPI number for Mohammad Samara is 1679145460. It was assigned to this individual provider in the NPPES registry on July 12, 2021.

Where is Mohammad Samara located?

Mohammad Samara practices at 2799 W Grand Blvd # 517, Detroit, MI 48202. The listed phone number is (313) 916-7134.

What is Mohammad Samara's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Mohammad Samara enrolled in Medicare?

Yes. Mohammad Samara is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mohammad Samara was last updated on June 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.