Jason J Rizqallah, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

4301101552 Issued in MI

Practice address

47601 Grand River Ave # B136
Novi, MI 48374

Phone

(248) 465-3940

Fax

(248) 465-3941

NPI assigned

Jul 21, 2012

Last updated

Sep 6, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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 1

Specialty

General Surgery

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Acute Care Surgeons PCGroup PAC ID 6002956265, 15 clinicians

Henry Ford Health Providence HospitalGroup PAC ID 6103738703, 364 clinicians

Henry Ford Health Macomb Oakland HospitalGroup PAC ID 7315859725, 155 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019
• Henry Ford Health Warren Hospital Hospital, Warren, MI, CCN 230195
• Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jrizqallah1149211@direct.hfhs.org

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.

• Henry Ford Health Macomb-Oakland Hospital

  dba Henry Ford Warren Hospital

  • Family Medicine Physician
  • Warren, MI
  • NPI 1134176472

  Surgery

  Medicare reassignment Care Compare group NPD
• Henry Ford Health Providence Hospital

  dba Henry Ford Providence Hospital

  • Surgery Physician
  • Southfield, MI
  • NPI 1942265236
  Medicare reassignment Care Compare group NPD
• Acute Care Surgeons PC

  • Trauma Surgery Physician
  • Detroit, MI
  • NPI 1730415753
  Medicare reassignment Care Compare group
• Henry Ford Health Macomb-Oakland Hospital

  dba Henry Ford Warren Hospital

  • Social Worker
  • Warren, MI
  • NPI 1548609761
  NPD
• Henry Ford Health Providence Hospital

  dba Henry Ford Providence Hospital

  • Pediatrics Physician
  • Southfield, MI
  • NPI 1265497226
  NPD
• Ascension Medical Group Michigan

  dba Henry Ford Semi Medical Group

  • Family Medicine Physician
  • Clinton Township, MI
  • NPI 1396913893
  NPD (past)
• Critical Care Surgeons PLLC

  • Trauma Surgery Physician
  • Detroit, MI
  • NPI 1710213731
  NPD (past)
• Henry Ford Health Macomb Oakland Hospital

  dba St John Macomb Oakland - Oakland Center

  • General Acute Care Hospital
  • Madison Heights, MI
  • NPI 1215139233
  NPD (past)
• Henry Ford Health Providence Hospital

  • General Acute Care Hospital
  • Novi, MI
  • NPI 1144210253
  NPD (past)

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

• Henry Ford Health Macomb Oakland Hospital

  dba St. John Macomb Oakland Hospital-Warren Campus

  • General Acute Care Hospital
  • Warren, MI
  • NPI 1124099858
  Care Compare affiliation
• Henry Ford Health Macomb Oakland Hospital

  dba St John Macomb Oakland - Oakland Center

  • General Acute Care Hospital
  • Madison Heights, MI
  • NPI 1215139233
  Care Compare affiliation
• Henry Ford Health Providence Hospital

  • General Acute Care Hospital
  • Novi, MI
  • NPI 1144210253
  Care Compare affiliation
• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Care Compare affiliation

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

{
    "created_epoch": "1342828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536192000000",
    "number": "1043565443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47601 GRAND RIVER AVE # B136",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483741233",
            "telephone_number": "248-465-3940",
            "fax_number": "248-465-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47601 GRAND RIVER AVE # B136",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "48374",
            "telephone_number": "248-465-3940",
            "fax_number": "248-465-3941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3663 Woodward Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012400",
            "country_code": "US",
            "telephone_number": "313-745-6035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIZQALLAH",
        "first_name": "JASON",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-21",
        "last_updated": "2018-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301101552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Israel Rivera
• Maya Rivera
• Raquel Rivera
• Carolyn Jewell Rivers
• Rivi Medical Associates PLC
• Ruby Rizwan, MS
• Taylor Robb
• Abigail L Robbins
• Charmayne Robbins
• Janese Camille Roberson

• Surgery Physician in Novi, MI
• Providers in Novi, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.