Individual provider Active NPI

Derek Bair, MD

  • Neonatal-Perinatal Medicine Physician
  • Dearborn, MI
National Provider Identifier
1174503049
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
4301062804 Issued in MI
Practice address
18101 Oakwood Blvd Ste 124
Dept of Neonatology
Dearborn, MI 48124-4089
Phone
(313) 593-7490
Fax
(313) 736-2082
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 4301062804 MI Primary

Addresses

Primary practice location

18101 Oakwood Blvd Ste 124
Dept of Neonatology
Dearborn, MI 48124-4089

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849

Other practice location 1

18501 Rotunda Dr Ste 200
Dearborn, MI 48124-3891
Phone (313) 996-1960

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dbair96666@direct.beaumont.edu

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
I20181121000923 MI Practitioner - Pediatric Medicine 6002160454 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont Medical Group Hospital -Based Services CurrentSince Nov 12, 2018 Accepting new patients
Oakwood Healthcare, Inc. Past Accepting new patients

Locations

18101 Oakwood Blvd
Ste 124
Dearborn, MI 48124
Phone (313) 593-7490

18501 Rotunda Dr
Ste 200
Dearborn, MI 48124
Phone (313) 996-1936

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

Interoperability endpoints

  • Direct secure messaging: dbair1224215@epic00.shdirect.org

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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1174503049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD STE 124",
            "address_2": "DEPT OF NEONATOLOGY",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244089",
            "telephone_number": "313-593-7490",
            "fax_number": "313-736-2082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18501 Rotunda Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481243891",
            "country_code": "US",
            "telephone_number": "313-996-1960",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAIR",
        "first_name": "DEREK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MI",
            "license": "4301062804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dbair96666@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "18101 Oakwood Blvd Ste 124",
            "address_2": "Dept of Neonatology",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481244089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.