Organization Active NPI

Thamer Medical PLLC

  • Internal Medicine Physician
  • Dearborn, MI
National Provider Identifier
1194135186
Registry record updated Apr 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301080367 Issued in MI
Legal business name
THAMER MEDICAL PLLC
Practice address
2040 Monroe St
Suite 206
Dearborn, MI 48124-2950
Phone
(313) 561-8796
Fax
(313) 561-0277
NPI assigned
Apr 30, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2014

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

Authorized official

Name
Dr. Jawad ThamerNPI 1972573731
Title
Owner Physician
Phone
(313) 561-8796

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
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 4301080367 MI Primary

Addresses

Primary practice location

2040 Monroe St
Suite 206
Dearborn, MI 48124-2950

Mailing address

2040 Monroe St
Suite 206
Dearborn, MI 48124-2950
Phone (313) 561-8796

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140624002412 MI Part B Supplier - Clinic/Group Practice 0547484024 Receives reassigned benefits from 3 practitioners
Practice locations: Dearborn, 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
23D2081227Thamer Medical PLLC2040 Monroe Street Suite 206, Dearborn, MI 48124Certificate of waiverJul 21, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1398816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398816000000",
    "number": "1194135186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 MONROE ST",
            "address_2": "SUITE 206",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242950",
            "telephone_number": "313-561-8796",
            "fax_number": "313-561-0277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 MONROE ST",
            "address_2": "SUITE 206",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242950",
            "telephone_number": "313-561-8796",
            "fax_number": "313-561-0277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THAMER MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-30",
        "last_updated": "2014-04-30",
        "status": "A",
        "authorized_official_last_name": "THAMER",
        "authorized_official_first_name": "JAWAD",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "313-561-8796",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301080367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2014; 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.