Organization Active NPI

Michigan Women's Care, PLLC

  • Obstetrics & Gynecology Physician
  • Canton, MI
National Provider Identifier
1174630115
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
MICHIGAN WOMEN'S CARE, PLLC
Practice address
6300 N Haggerty Rd Ste 200
Canton, MI 48187-4472
Phone
(734) 981-8181
NPI assigned
Aug 24, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Essam Khraizat, M.D.NPI 1508846577
Title
Medical Director
Phone
(248) 470-6122

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MI Primary

Addresses

Primary practice location

6300 N Haggerty Rd Ste 200
Canton, MI 48187-4472

Mailing address

6300 N Haggerty Road
Suite 200
Canton, MI 48187-3338
Phone (734) 981-8181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061101000229 MI Part B Supplier - Clinic/Group Practice 7113924325 Receives reassigned benefits from 4 practitioners
Practice locations: Dearborn, MI; Canton, MI

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D1058825Michigan Women's Care PLLC6300 N Haggerty Road Suite 200, Canton, MI 48187Certificate of waiverJul 26, 2027

National Provider Directory

National Provider Directory

Locations

2100 Monroe St
Dearborn, MI 48124
Phone (313) 278-3900

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15822/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1174630115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 N HAGGERTY ROAD",
            "address_2": "SUITE 200",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481873338",
            "telephone_number": "734-981-8181",
            "fax_number": "734-981-1259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 N HAGGERTY RD STE 200",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481874472",
            "telephone_number": "734-981-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN WOMEN'S CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KHRAIZAT",
        "authorized_official_first_name": "ESSAM",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "248-470-6122",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.