NPIMap

Organization Active NPI

Hazimeh Primary Care PLLC

  • Multi-Specialty Clinic/Center
  • Dearborn, MI
National Provider Identifier
1194364984
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
HAZIMEH PRIMARY CARE PLLC
Practice address
7534 Wyoming St
Dearborn, MI 48126-1690
Phone
(313) 455-9765
NPI assigned
Dec 27, 2019
Last updated
Jul 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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

Authorized official

Name
Ali HazimehNPI 1437413721
Title
President / Owner
Phone
(313) 415-1515

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

7534 Wyoming St
Dearborn, MI 48126-1690

Mailing address

7534 Wyoming St
Dearborn, MI 48126-1690
Phone (313) 455-9765

Other names 1

  • Hazimeh primary care PLLC Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL eCW

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200103001374 MI Part B Supplier - Clinic/Group Practice 2062846876 Receives reassigned benefits from 15 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dearborn, MI
O20210129001390 MI Part B Supplier - Clinic/Group Practice 1557775756 Receives reassigned benefits from 13 practitioners
Practice locations: Dearborn, MI; Detroit, MI; Hamtramck, MI; Riverview, MI; Westland, MI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

7526 Wyoming St
Dearborn, MI 48126
Phone (313) 491-1010

3702 Oakwood Blvd
Melvindale, MI 48122
Phone (313) 415-1515

1651 S Venoy Rd
Ste B
Westland, MI 48186
Phone (313) 663-9000

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1577404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657843200000",
    "number": "1194364984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7534 WYOMING ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261690",
            "telephone_number": "313-455-9765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7534 WYOMING ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261690",
            "telephone_number": "313-455-9765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAZIMEH PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-27",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A",
        "authorized_official_last_name": "HAZIMEH",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "PRESIDENT / OWNER",
        "authorized_official_telephone_number": "313-415-1515"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "eCW",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "address_1": "7542 Wyoming St",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481261690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Hazimeh primary care PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Hazimeh primary care PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Jul 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.