NPIMap

Individual provider Active NPI

Ali H Dabaja, DO

  • Emergency Medicine Physician
  • Dearborn, MI
National Provider Identifier
1053688952
Registry record updated Jan 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
66361 Issued in WI
Practice address
116 S Denwood St
Dearborn, MI 48124-1310
Phone
(734) 266-2780
Fax
(734) 466-9615
NPI assigned
Nov 20, 2011
Last updated
Jan 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101020852 MI
Emergency Medicine Physician 207P00000X 66361 WI Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 5101020852 MI

Addresses

Primary practice location

116 S Denwood St
Dearborn, MI 48124-1310

Mailing address

Dept 259301
P O Box 67000
Detroit, MI 48267-2593
Phone (734) 266-2780

Other identifiers 1

IdentifierTypeStateIssuer
1053688952MedicaidMI

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
I20140728000687 MI Practitioner - Critical Care (Intensivists)Practitioner - Emergency MedicinePractitioner - Pulmonary Disease 6901051580 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Pulmonary Disease
Education
Michigan State University College of Osteopathic Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone (313) 593-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101020852MIMDEmergency Medicine Physician
66361WIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary Mercy Hospital Crna Current Accepting new patients
Critical Care Medicine Partners, PC Emergency Medicine CurrentSince Aug 24, 2015 Accepting new patients
St Mary Mercy Hospital Professional CurrentSince Apr 24, 2020 Accepting new patients
Critical Care Medicine Partners, PC CurrentSince Aug 24, 2015 Accepting new patients
St Mary Mercy Hospital Professional CurrentSince Apr 24, 2020 Accepting new patients
Emergency Professionals of Michigan, P.C. Emergency Medicine CurrentSince Jul 1, 2014 Accepting new patients

Locations

7300 N Canton Center Rd
Canton, MI 48187
Phone (734) 454-8001

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

20555 Victor Pkwy
Livonia, MI 48152
Phone (734) 343-3925

36475 5 Mile Rd
Livonia, MI 48154
Phone (734) 464-4800

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

10000 Telegraph Rd
Taylor, MI 48180
Phone (313) 295-5000

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

Interoperability endpoints

  • Direct secure messaging: adabaja695057@direct.hfhs.org

Organizations & group practices 6

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 7

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": "1321747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1053688952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 259301",
            "address_2": "P O BOX 67000",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482672593",
            "telephone_number": "734-266-2780",
            "fax_number": "734-466-9615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 S DENWOOD ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241310",
            "telephone_number": "734-266-2780",
            "fax_number": "734-466-9615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DABAJA",
        "first_name": "ALI",
        "middle_name": "H",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-20",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101020852",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "66361",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MI",
            "license": "5101020852",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053688952",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.