Organization Active NPI

Alex Bouhachem DPM PC

  • Foot & Ankle Surgery Podiatrist
  • Dearborn, MI
National Provider Identifier
1124237516
Registry record updated Oct 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
ALEX BOUHACHEM DPM PC
Practice address
12940 W Warren Ave
Dearborn, MI 48126-1535
Phone
(734) 895-4530
Fax
(313) 447-2280
NPI assigned
May 22, 2007
Last updated
Oct 20, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2026

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

Authorized official

Name
Alex Bouhachem, DPMNPI 1912905340
Title
Ceo
Phone
(313) 406-4201

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary
Durable Medical Equipment & Medical Supplies 332B00000X 5901002050 MI

Addresses

Primary practice location

12940 W Warren Ave
Dearborn, MI 48126-1535

Mailing address

1813 N Rosevere Ave
Dearborn, MI 48128-1242
Phone (313) 406-4201

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930036372 MI DME Supplier - Physician - Podiatry 3779592241 Practice locations: Dearborn, MI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

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": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792454400000",
    "number": "1124237516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1813 N ROSEVERE AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281242",
            "telephone_number": "313-406-4201",
            "fax_number": "313-406-4293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12940 W WARREN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261535",
            "telephone_number": "734-895-4530",
            "fax_number": "313-447-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEX BOUHACHEM DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2026-10-20",
        "certification_date": "2026-10-20",
        "status": "A",
        "authorized_official_last_name": "BOUHACHEM",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-406-4201",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": "5901002050",
            "primary": false
        }
    ],
    "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 Oct 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.