Individual provider Active NPI

Ayman E Tadros, MD

  • Family Medicine Physician
  • Grand Blanc, MI
National Provider Identifier
1205938974
Registry record updated Nov 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301057623 Issued in MI
Practice address
2070 E Hill Rd
Grand Blanc, MI 48439-5108
Phone
(810) 695-5353
Fax
(810) 695-0616
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301057623 MI Primary

Addresses

Primary practice location

2070 E Hill Rd
Grand Blanc, MI 48439-5108

Mailing address

2070 E Hill Rd
Grand Blanc, MI 48439-5108
Phone (810) 695-5353

Other identifiers 1

IdentifierTypeStateIssuer
3274626MedicaidMI

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
I20100205000629 MI Practitioner - Family Practice 3375686892 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Medical Group GenesysGroup PAC ID 7214288281, 96 clinicians

Practice addresses (Care Compare)

2070 E Hill Rd
Grand Blanc, MI 48439-5108
Phone (810) 695-5353

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Genesys Pho LLC CurrentSince Apr 3, 2018 Accepting new patients
Henry Ford Medical Group Genesys Family Medicine Current Accepting new patients
Henry Ford Medical Group Genesys Family Medicine CurrentSince Aug 21, 2018 Accepting new patients
Henry Ford Medical Group Genesys CurrentSince Aug 21, 2018 Accepting new patients

Locations

2184 S Ballenger Hwy
Flint, MI 48503
Phone (810) 232-5627

3495 S Center Rd
Flint, MI 48519
Phone (810) 424-2025

307 E Court St
Flint, MI 48502
Phone (810) 341-7370

2070 E Hill Rd
Grand Blanc, MI 48439
Phone (810) 695-5353

10785 S Saginaw St
Ste D
Grand Blanc, MI 48439
Phone (810) 695-6337

Interoperability endpoints

  • Direct secure messaging: aymantadros@pmi.allscriptsdirect.net
  • Direct secure messaging: atadros1155104@direct.hfhs.org

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322438400000",
    "number": "1205938974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2070 E HILL RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484395108",
            "telephone_number": "810-695-5353",
            "fax_number": "810-695-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2070 E HILL RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484395108",
            "telephone_number": "810-695-5353",
            "fax_number": "810-695-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TADROS",
        "first_name": "AYMAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2011-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301057623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3274626",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.