Individual provider Active NPI

Mona Kassem

  • Cardiovascular Disease Physician
  • Dearborn, MI
National Provider Identifier
1063360683
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
5601013636 Issued in MI
Practice address
15355 Prospect St
Dearborn, MI 48126-2955
Phone
(313) 231-5281
NPI assigned
Mar 19, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 5601013636 MI Primary

Addresses

Primary practice location

15355 Prospect St
Dearborn, MI 48126-2955

Mailing address

15355 Prospect St
Dearborn, MI 48126-2955
Phone (313) 231-5281

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260501000449 MI Practitioner - Physician Assistant 5496222085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

15355 Prospect St
Dearborn, MI 48126-2955

22720 Michigan Ave
Suite 200
Dearborn, MI 48124-2021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5601013636MIMDCardiovascular Disease Physician

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": "1773878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773878400000",
    "number": "1063360683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15355 PROSPECT ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262955",
            "telephone_number": "313-231-5281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15355 PROSPECT ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262955",
            "telephone_number": "313-231-5281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSEM",
        "first_name": "MONA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-19",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "5601013636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.