Individual provider Active NPI

Mazen Naseeb Hamameh, D.O.

  • Pediatrics Physician
  • Dearborn Heights, MI
National Provider Identifier
1215142153
Registry record updated Jan 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
1 Issued in MI
Practice address
22350 Ford Rd
Dearborn Heights, MI 48127-2421
Phone
(313) 278-2788
NPI assigned
May 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 1 MI Primary

Addresses

Primary practice location

22350 Ford Rd
Dearborn Heights, MI 48127-2421

Mailing address

5831 Whitefield St
Dearborn Heights, MI 48127-4812
Phone (313) 505-0895

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
I20120210000736 MI Practitioner - Pediatric Medicine 1850558339 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oakwood Ambulatory LLC Pediatrics CurrentSince Oct 1, 2011 Accepting new patients
Oakwood Ambulatory, LLC CurrentSince Oct 1, 2011 Accepting new patients
Beaumont Medical Group Hospital -Based Services CurrentSince Jan 1, 2019 Accepting new patients
Premier Pediatrics Pediatrics Past Accepting new patients

Locations

201 3rd St
Ste 200
Belleville, MI 48111
Phone (734) 697-9065

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FHBBDA/Endpoint/FHBBDA

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.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422230400000",
    "number": "1215142153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5831 WHITEFIELD ST",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481274812",
            "telephone_number": "313-505-0895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22350 FORD RD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481272421",
            "telephone_number": "313-278-2788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMAMEH",
        "first_name": "MAZEN",
        "middle_name": "NASEEB",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2015-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn Heights, MI

Sources for this page

Verify at the official NPI Registry.