Riad R. Hajjar MD PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

RH066725 Issued in MI

Legal business name

RIAD R. HAJJAR MD PC

Practice address

1201 Stone St
Ste 5
Port Huron, MI 48060-3563

Phone

(810) 966-9556

Fax

(810) 966-4898

NPI assigned

Jul 5, 2007

Organization subpart

No

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

Authorized official

Name

Carol Klann

Title

Office Manager

Phone

(810) 966-9556

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Riad Robert Hajjar, M.D.

  • Internal Medicine Physician
  • Port Huron, MI
  • NPI 1538153176
  Medicare reassignment NPD
• Jaclyn Kamidoi

  • Nurse Practitioner
  • Port Huron, MI
  • NPI 1992202998
  Medicare reassignment NPD
• Ronaldo S Balboa, M.D.

  • Internal Medicine Physician
  • Port Huron, MI
  • NPI 1417941055
  NPD
• Neil S Millman, DO

  • Adult Medicine Physician
  • Farmington, MI
  • NPI 1912911447
  NPD (past)

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261008000000",
    "number": "1164620753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 STONE ST",
            "address_2": "STE 5",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603563",
            "telephone_number": "810-966-9556",
            "fax_number": "810-966-4898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 STONE ST",
            "address_2": "STE 5",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603563",
            "telephone_number": "810-966-9556",
            "fax_number": "810-966-4898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIAD R. HAJJAR MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-05",
        "last_updated": "2009-12-17",
        "status": "A",
        "authorized_official_last_name": "KLANN",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "810-966-9556"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "RH066725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA-RAILROAD MED",
            "identifier": "D5959",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY CODE",
            "identifier": "207R00000X",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4263408",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renal Center Physicians
• Casey Renno, AGNP-C
• Kaitlyn Reno
• Jason Gerald Rewalt, CRNA
• Laura Reynolds
• Gerald M Rice, CRNA
• Madison Leigh Rich I
• Danielle Richard
• Natalie Richard, LMSW
• Erika Richards

• Internal Medicine Physician in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.