Organization Active NPI

Hassan Dakroub MD PLLC

  • Multi-Specialty Clinic/Center
  • Dearborn, MI
National Provider Identifier
1114262540
Registry record updated Dec 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
4301087179 Issued in MI
Legal business name
HASSAN DAKROUB MD PLLC
Practice address
3735 Monroe St Ste a
Dearborn, MI 48124-3787
Phone
(313) 914-3370
Fax
(313) 908-9128
NPI assigned
Dec 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2017

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

Authorized official

Name
Hassan Dakroub, MDNPI 1528099397
Title
Owner
Phone
(313) 914-3370

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 4301087179 MI Primary

Addresses

Primary practice location

3735 Monroe St Ste a
Dearborn, MI 48124-3787

Mailing address

3735 Monroe St Ste a
Dearborn, MI 48124-3787
Phone (313) 914-3370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130416000496 MI Part B Supplier - Clinic/Group Practice 0648416768 Receives reassigned benefits from 1 practitioner
Practice locations: Dearborn, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2090031Hassan Dakroub MD PLLC3735 Monroe Street Suite a, Dearborn, MI 48124Certificate of waiverJan 13, 2027

National Provider Directory

National Provider Directory

Locations

3735 Monroe St
Ste A
Dearborn, MI 48124
Phone (313) 277-6560

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1355270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512950400000",
    "number": "1114262540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3735 MONROE ST STE A",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243787",
            "telephone_number": "313-914-3370",
            "fax_number": "313-908-9128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3735 MONROE ST STE A",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243787",
            "telephone_number": "313-914-3370",
            "fax_number": "313-908-9128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HASSAN DAKROUB MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-12",
        "last_updated": "2017-12-11",
        "status": "A",
        "authorized_official_last_name": "DAKROUB",
        "authorized_official_first_name": "HASSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-914-3370",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "MI",
            "license": "4301087179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.