NPIMap

Organization Active NPI

Mdslivenow PLLC

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1215688965
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MDSLIVENOW PLLC
Practice address
4100 Woodward Ave
Detroit, MI 48201-2173
Phone
(313) 974-6533
NPI assigned
Jan 14, 2022
Last updated
Mar 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Authorized official

Name
Hassan Bazzi, DONPI 1457507006
Title
Manager
Phone
(313) 231-4716

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 Physician 207R00000X Primary

Addresses

Primary practice location

4100 Woodward Ave
Detroit, MI 48201-2173

Mailing address

6473 Chase Rd
Dearborn, MI 48126-2138

Other practice location 1

25535 Ford Rd
Dearborn Heights, MI 48127-3021
Phone (313) 977-5100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220329002421 MI Part B Supplier - Clinic/Group Practice 7214323336 Receives reassigned benefits from 44 practitioners
Practice locations: Canton, MI; Portage, MI; Livonia, MI; Garden City, MI; Detroit, 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
23D2253454Mdslivenow PLLC4100 Woodward Avenue, Detroit, MI 48201Certificate of waiverFeb 21, 2028

National Provider Directory

National Provider Directory

Locations

25535 Ford Rd
Dearborn Heights, MI 48127
Phone (313) 977-5100

Practitioners & affiliated clinicians

Practitioners 48

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 48

NPI Registry JSON

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

{
    "created_epoch": "1642118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648512000000",
    "number": "1215688965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6473 CHASE RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 WOODWARD AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012173",
            "telephone_number": "313-974-6533"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25535 Ford Rd",
            "address_purpose": "LOCATION",
            "city": "Dearborn Heights",
            "state": "MI",
            "postal_code": "481273021",
            "country_code": "US",
            "telephone_number": "313-977-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MDSLIVENOW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-14",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A",
        "authorized_official_last_name": "BAZZI",
        "authorized_official_first_name": "HASSAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "313-231-4716",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; 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.