Individual provider Active NPI

Diana Ali Haidar, M.D.

  • Internal Medicine Physician
  • Southfield, MI
National Provider Identifier
1154763274
Registry record updated Oct 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301104154 Issued in MI
Practice address
29275 Northwestern Hwy Ste 200
Southfield, MI 48034
Phone
(248) 423-7000
Fax
(248) 423-7077
NPI assigned
Jul 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301104154 MI Primary

Addresses

Primary practice location

29275 Northwestern Hwy Ste 200
Southfield, MI 48034

Mailing address

29275 Northwestern Hwy Ste 200
Southfield, MI 48034-5744
Phone (248) 423-7000

Other practice location 1

29275 Northwestern Hwy Ste 200
Southfield, MI 48034
Phone (248) 423-7000

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
I20160810001297 MI Practitioner - Family Practice 5496057093 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Semi Medical GroupGroup PAC ID 0648180406, shared by 4 NPIs, 246 clinicians

Practice addresses (Care Compare)

24333 Orchard Lake Rd
Suite C
Farmington Hills, MI 48336-1976
Phone (248) 476-0660

Hospital & facility affiliations

  • Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019
  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301104154MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Semi Medical Group Internal Medicine Current Accepting new patients
Henry Ford Semi Medical Group Internal Medicine CurrentSince Jun 1, 2021 Accepting new patients
Henry Ford Semi Medical Group Internal Medicine CurrentSince May 1, 2019 Accepting new patients
Henry Ford Semi Medical Group CurrentSince May 1, 2019 Accepting new patients
SJMH Medical Practice-SMHC Internal Medicine Past Accepting new patients

Locations

33523 8 Mile Rd
Ste M2
Livonia, MI 48152
Phone (248) 824-2675

26850 Providence Pkwy
Ste 520
Novi, MI 48374
Phone (248) 465-3790

30117 Schoenherr Rd
Ste 400
Warren, MI 48088
Phone (586) 552-4848

Interoperability endpoints

  • Direct secure messaging: dhaidar1131038@direct.hfhs.org

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1374105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1154763274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29275 NORTHWESTERN HWY STE 200",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480345744",
            "telephone_number": "248-423-7000",
            "fax_number": "248-423-7077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29275 NORTHWESTERN HWY STE 200",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48034",
            "telephone_number": "248-423-7000",
            "fax_number": "248-423-7077"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29275 Northwestern Hwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "48034",
            "country_code": "US",
            "telephone_number": "248-423-7000",
            "fax_number": "248-423-7077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAIDAR",
        "first_name": "DIANA",
        "middle_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-18",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301104154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.