Active NPI
Mostafa Ghulam Hazrat
- Podiatric Assistant
- Grand Blanc, MI
National Provider Identifier
1194659730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatric Assistant
- License
- 5951001611
- Practice address
- 1 Genesys Pkwy
Grand Blanc, MI 48439-8065 - Phone
- (810) 606-5987
- NPI assigned
- Jun 10, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatric Assistant | 211D00000X | 5951001611 | MI | Primary |
Addresses
Primary practice location
1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Mailing address
1275 Heatherwood Dr Apt 7450-3B
Grand Blanc, MI 48439-9293
Phone (602) 321-2693
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1781049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781049600000",
"number": "1194659730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1275 HEATHERWOOD DR APT 7450-3B",
"city": "GRAND BLANC",
"state": "MI",
"postal_code": "484399293",
"telephone_number": "602-321-2693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 GENESYS PKWY",
"city": "GRAND BLANC",
"state": "MI",
"postal_code": "484398065",
"telephone_number": "810-606-5987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHULAM HAZRAT",
"first_name": "MOSTAFA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-06-10",
"last_updated": "2026-06-10",
"certification_date": "2026-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "211D00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Assistant, Podiatric",
"state": "MI",
"license": "5951001611",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Blanc, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.