Active NPI
Alex Bouhachem DPM PC
- Durable Medical Equipment & Medical Supplies
- Dearborn, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 5901002050
- Legal business name
- ALEX BOUHACHEM DPM PC
- Practice address
- 10801 W Warren Ave
Dearborn, MI 48126-1191 - Phone
- (313) 406-4201
- Fax
- (313) 406-4293
- NPI assigned
- May 22, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Alex Bouhachem, DPM
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | |||
| Durable Medical Equipment & Medical Supplies | 332B00000X | 5901002050 | MI | Primary |
Addresses
Primary practice location
10801 W Warren Ave
Dearborn, MI 48126-1191
Mailing address
1813 N Rosevere Ave
Dearborn, MI 48128-1242
Phone (313) 406-4201
Other practice location 1
10801 W Warren Ave
Dearborn, MI 48126-1191
Phone (734) 895-4530
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations
23801 W Warren St
Ste 102
Dearborn Heights, MI 48127
Phone (734) 895-4530
23801 W Warren St
Dearborn Hts, MI 48127
Phone (313) 908-5856
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Foot & Ankle Surgery Podiatrist
- Dearborn, MI
- NPI 1912905340
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": "1737676800000",
"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": "10801 W WARREN AVE",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481261191",
"telephone_number": "313-406-4201",
"fax_number": "313-406-4293"
}
],
"practiceLocations": [
{
"address_1": "10801 W Warren Ave",
"address_purpose": "LOCATION",
"city": "Dearborn",
"state": "MI",
"postal_code": "481261191",
"country_code": "US",
"telephone_number": "734-895-4530",
"fax_number": "313-447-3234",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "ALEX BOUHACHEM DPM PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-22",
"last_updated": "2025-01-24",
"certification_date": "2025-01-24",
"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": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "MI",
"license": "5901002050",
"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 Jan 24, 2025; 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.