TAMARA MABROUK
NPI 1700456928
Student in an Organized Health Care Education/Training Program in Detroit, MI

Q: What is Tamara Mabrouk's NPI number?

The NPI number for Tamara Mabrouk is 1700456928. It was assigned to this individual provider in the NPPES registry on June 29, 2021.

Q: What is Tamara Mabrouk's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Tamara Mabrouk was last updated on June 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since June 29, 2021PECOS Enrolled

22101 MOROSS RD, DETROIT, MI 48236(313) 343-4000 Get Directions Write a Review

NPPES record last updated: June 29, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Tamara Mabrouk NPPES

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

TAMARA MABROUK (NPI 1700456928) is an individual student in an organized health care education/training program in Detroit, Michigan and active in the NPI registry since June 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1700456928

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameTAMARA MABROUK

Location Address22101 MOROSS RDDetroit, MI 48236-2148

Mailing Address1632 Stone StSaginaw, MI 48602 · (989) 583-0000

Phone(313) 343-4000

Sole ProprietorNo

Enumeration DateJune 29, 2021

NPPES CertifiedJune 29, 2021

✔ NPI 1700456928 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.

22101 MOROSS RD, Detroit, MI 48236

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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)

Tamara Mabrouk 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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARY DECAROLIS LMSW, ACSW

Social Worker (Clinical)