Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Alaa Eddin Tahboub, PA-C

Individual provider Medical Physician Assistant · NPI 1689225443

Alaa Eddin Tahboub, PA-C is a Physician Assistant in Detroit, Michigan. Qualified in 2019, 7 years ago. Practices with Osf Multi-Specialty Group, a 2,128-clinician group and accepts Medicare assignment. Licensed in Illinois and Michigan.

Years since qualifying
7
Licensed in
IL, MI
In the registry since
2019
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4771 Michigan Ave
Detroit, MI 48210-9718
Phone: (313) 897-2600
Fax: (313) 897-2424
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 085007807 (IL)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 5601009631 (MI)

Record details

NPI number1689225443
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 24, 2019
Last updated in NPPESDecember 13, 2024
Certification dateDecember 13, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Osf Multi-Specialty Group — 2128 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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