Individual provider Active NPI

Thomas John Zahari

  • Pediatrics Physician
  • Shelby Township, MI
National Provider Identifier
1053975391
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
5101026661 Issued in MI
Practice address
15125 22 Mile Rd
Shelby Township, MI 48315-4406
Phone
(586) 532-0599
NPI assigned
Apr 23, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 5101026661 MI Primary

Addresses

Primary practice location

15125 22 Mile Rd
Shelby Township, MI 48315-4406

Mailing address

15125 22 Mile Rd
Shelby Township, MI 48315-4406
Phone (586) 532-0599

Other practice location 1

44472 Bayview Ave Apt 15303
Clinton Township, MI 48038-7016
Phone (734) 308-9164

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190617002486 MI Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 4880927201

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101026661MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shelby Pediatric Associates and Child Lung Center PC Pediatrics CurrentSince Dec 13, 2022 Accepting new patients

Locations

36555 26 Mile Rd
Ste 2100
Lenox, MI 48048
Phone (586) 532-0599

15125 22 Mile Rd
Shelby Township, MI 48315
Phone (586) 532-0599

Interoperability endpoints

  • Direct secure messaging: thomas.zahari.1@7131.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1053975391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15125 22 MILE RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483154406",
            "telephone_number": "586-532-0599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15125 22 MILE RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483154406",
            "telephone_number": "586-532-0599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44472 Bayview Ave Apt 15303",
            "address_purpose": "LOCATION",
            "city": "Clinton Township",
            "state": "MI",
            "postal_code": "480387016",
            "country_code": "US",
            "telephone_number": "734-308-9164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAHARI",
        "first_name": "THOMAS",
        "middle_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-23",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101026661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

Verify at the official NPI Registry.