NPIMap

Individual provider Active NPI

Sami M Baraka, MD

  • Family Medicine Physician
  • Wyandotte, MI
National Provider Identifier
1003874082
Registry record updated Apr 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301058513 Issued in MI
Practice address
1622 Eureka Rd
Wyandotte, MI 48192-6104
Phone
(734) 282-0600
Fax
(734) 282-0500
NPI assigned
May 1, 2006
Last updated
Apr 3, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301058513 MI Primary

Addresses

Primary practice location

1622 Eureka Rd
Wyandotte, MI 48192-6104

Mailing address

1622 Eureka Rd
Wyandotte, MI 48192-6104
Phone (734) 282-0600

Other identifiers 1

IdentifierTypeStateIssuer
3391669MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080212000696 MI Practitioner - Family Practice 1658454723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wayne State University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1622 Eureka Rd
Wyandotte, MI 48192-6104
Phone (734) 282-0600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue52
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sami M Baraka MD PC Family Medicine CurrentSince Oct 3, 1997 Accepting new patients
Oakwood Healthcare, Inc. Past Accepting new patients
Henry Ford Wyandotte Hospital Past Accepting new patients

Locations

1622 Eureka Rd
Wyandotte, MI 48192
Phone (734) 246-4577

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCIHBA/Endpoint/CCIHBA
  • Direct secure messaging: sbaraka61054@direct.hfhs.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207180800000",
    "number": "1003874082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1622 EUREKA RD",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481926104",
            "telephone_number": "734-282-0600",
            "fax_number": "734-282-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 EUREKA RD",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481926104",
            "telephone_number": "734-282-0600",
            "fax_number": "734-282-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARAKA",
        "first_name": "SAMI",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2008-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301058513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3391669",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyandotte, MI

Sources for this page

Verify at the official NPI Registry.