Individual provider Active NPI

Tareq Ismail Maraqa, MD

  • Family Medicine Physician
  • Flint, MI
National Provider Identifier
1134568181
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
72018 Issued in WI
Practice address
1 Hurley PLZ
Flint, MI 48503-5902
Phone
(810) 262-6023
NPI assigned
Jun 21, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery Physician 2086S0127X 4301112540 MI
Other Specialist/Technologist 246Z00000X 4061 DC
Family Medicine Physician 207Q00000X 72018 WI Primary

Addresses

Primary practice location

1 Hurley PLZ
Flint, MI 48503-5902

Mailing address

6348 Laurentian CT
Flint, MI 48532-2039
Phone (480) 619-7081

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20191113003310 WI Practitioner - Family PracticePractitioner - Peripheral Vascular Disease 1254689458 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Peripheral Vascular Disease
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vohra Wound Physicians of the Mid-West, S.C.Group PAC ID 9739467309, 13 clinicians

Practice addresses (Care Compare)

7500 W Dean Rd
Milwaukee, WI 53223-2695
Phone (877) 866-7123

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1300
Removal of skin lesions211

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72018WIMDFamily Medicine Physician
4301112540MIMDTrauma Surgery Physician
4061DCMDOther Specialist/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Vohra Wound Physicians of the Mid-West, S.C. Family Medicine CurrentSince Oct 28, 2019 Accepting new patients

Locations

3601 SW 160th Ave
Ste 250
Miramar, FL 33027
Phone (305) 866-9951

3601 S Chicago Ave
South Milwaukee, WI 53172
Phone (414) 570-5477

4545 N 92nd St
Wauwatosa, WI 53225
Phone (414) 464-3880

Organizations & group practices 1

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": "1371772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1134568181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6348 LAURENTIAN CT",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485322039",
            "telephone_number": "480-619-7081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HURLEY PLZ",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485035902",
            "telephone_number": "810-262-6023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARAQA",
        "first_name": "TAREQ",
        "middle_name": "ISMAIL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-21",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "MI",
            "license": "4301112540",
            "primary": false
        },
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "DC",
            "license": "4061",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "72018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.