Individual provider Active NPI

Imad Talib Zak, MD

  • Neuroradiology Physician
  • Detroit, MI
National Provider Identifier
1093811697
Registry record updated Oct 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
4301073875 Issued in MI
Practice address
4646 John R St
Detroit, MI 48201-1916
Phone
(313) 576-1000
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 4301073875 MI
Neuroradiology Physician 2085N0700X 4301073875 MI Primary

Addresses

Primary practice location

4646 John R St
Detroit, MI 48201-1916

Mailing address

2123 Aberdeen CT
Rochester, MI 48306-4929

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
I20040421000591 MI Practitioner - Diagnostic Radiology 7719973379 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renaissance Medical FoundationGroup PAC ID 1153409867, 178 clinicians

Practice addresses (Care Compare)

2123 Aberdeen CT
Rochester, MI 48306-4929
Phone (956) 362-7553

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301073875MIMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radadvantage a Professional Corporation Diagnostic Radiology CurrentSince Oct 31, 2018 Accepting new patients
Renaissance Medical Foundation CurrentSince Feb 8, 2025 Accepting new patients
VHS Physicians of Michigan CurrentSince Jan 16, 2024 Accepting new patients

Locations

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

3990 John R St
Detroit, MI 48201
Phone (313) 745-6211

5501 S McColl Rd
Edinburg, TX 78539
Phone (956) 362-3300

Organizations & group practices 3

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 5

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697932800000",
    "number": "1093811697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2123 ABERDEEN CT",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483064929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482011916",
            "telephone_number": "313-576-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAK",
        "first_name": "IMAD",
        "middle_name": "TALIB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2023-10-22",
        "certification_date": "2023-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301073875",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "MI",
            "license": "4301073875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.