Individual provider Active NPI

Lilliana Haddad, MD

  • Pediatrics Physician
  • Dearborn, MI
National Provider Identifier
1124641535
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301509535 Issued in MI
Practice address
12813 W Warren Ave
Dearborn, MI 48126-1532
Phone
(248) 880-4006
NPI assigned
May 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 4301509535 MI Primary

Addresses

Primary practice location

12813 W Warren Ave
Dearborn, MI 48126-1532

Mailing address

12813 W Warren Ave
Dearborn, MI 48126-1532
Phone (313) 581-8090

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
I20250415003940 MI Practitioner - Pediatric Medicine 5294156733 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Haddad Pediatrics PLLC Pediatrics CurrentSince Feb 3, 2025 Accepting new patients
Shaker Haddad MD PC CurrentSince Jul 2, 2023 Accepting new patients

Locations

12813 W Warren Ave
Dearborn, MI 48126
Phone (313) 581-8090

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CHJIDD/Endpoint/CHJIDD

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1124641535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12813 W WARREN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261532",
            "telephone_number": "313-581-8090",
            "fax_number": "313-581-4823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12813 W WARREN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261532",
            "telephone_number": "248-880-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDAD",
        "first_name": "LILLIANA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-20",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301509535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.