Individual provider Active NPI

Tamer Ghanem, M.D.

  • Otolaryngology Physician
  • Flint, MI
National Provider Identifier
1023185394
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
4301091603 Issued in MI
Practice address
G4007 W Court St Ste G2
Flint, MI 48532-3560
Phone
(810) 399-9931
Fax
(810) 382-2022
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 4301091603 MI Primary

Addresses

Primary practice location

G4007 W Court St Ste G2
Flint, MI 48532-3560

Mailing address

G4007 W Court St Ste G2
Flint, MI 48532-3560
Phone (810) 399-9931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080811000087 MI Practitioner - Otolaryngology 4880792704 Reassigns benefits to 2 organizations
I20230728001236 IN Practitioner - Otolaryngology 4880792704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Head and Neck Surgery PCGroup PAC ID 5597122978, 4 clinicians

Practice addresses (Care Compare)

5040 Villa Linde Pkwy
Suite a
Flint, MI 48532-3445
Phone (810) 399-9931

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301091603MIMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
W.a. Foote Memorial Hospital, Inc CurrentSince Apr 13, 2019 Accepting new patients
Deaconess Clinic, Inc. Otolaryngology CurrentSince Jun 14, 2023 Accepting new patients
Premier Head and Neck Surgery PC Plastic Surgery Within the Head & Neck CurrentSince Mar 29, 2023 Accepting new patients
Deaconess Clinic Inc CurrentSince Jun 14, 2023 Accepting new patients
Deaconess Clinic Inc. Current Accepting new patients
W. a. Foote Memorial Hospital, Inc Current Accepting new patients
W.a. Foote Memorial Hospital, Inc Otolaryngology CurrentSince Apr 13, 2019 Accepting new patients

Locations

350 W Columbia St
Ste 310
Evansville, IN 47710
Phone (812) 425-2646

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

4015 Gateway Blvd
Newburgh, IN 47630
Phone (812) 858-6244

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

G4007 W Court St
Ste G2
Flint, MI 48532
Phone (810) 230-0444

5040 Villa Linde Pkwy
Ste A
Flint, MI 48532
Phone (810) 720-9290

1111 Teneyck St
Ste 100
Jackson, MI 49201
Phone (517) 205-8940

813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000

Interoperability endpoints

  • Direct secure messaging: tghanem3099692@direct.trinity-health.org
  • Direct secure messaging: tghanem16954@direct.hfhs.org
  • Direct secure messaging: tghanem237266@direct.deaconess.com

Organizations & group practices 7

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

Hospital & facility affiliations 2

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": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1023185394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "G4007 W COURT ST STE G2",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323560",
            "telephone_number": "810-399-9931",
            "fax_number": "810-382-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "G4007 W COURT ST STE G2",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323560",
            "telephone_number": "810-399-9931",
            "fax_number": "810-382-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHANEM",
        "first_name": "TAMER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "4301091603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.