Organization Active NPI

Alex Bouhachem DPM PC

  • Durable Medical Equipment & Medical Supplies
  • Dearborn, MI
National Provider Identifier
1124237516
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
5901002050 Issued in MI
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

Updated by the provider on Jan 24, 2025

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
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 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

Locations

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.

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.

Verify at the official NPI Registry.