Organization Active NPI

Rostam Adult and Pediatric Medicine PLLC

  • Family Medicine Physician
  • Bad Axe, MI
National Provider Identifier
1235638651
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ROSTAM ADULT AND PEDIATRIC MEDICINE PLLC
Practice address
262 S PT Crescent St
Bad Axe, MI 48413-9635
Phone
(989) 493-9327
Fax
(989) 623-0172
NPI assigned
Feb 12, 2018
Last updated
May 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Authorized official

Name
Dr. Behzod Rostam, MDNPI 1902125677
Title
Owner
Phone
(248) 930-6442

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

262 S PT Crescent St
Bad Axe, MI 48413-9635

Mailing address

1121 Carrie Lynn Dr
Bay City, MI 48706-9399
Phone (248) 930-6442

Other practice location 1

1080 S Van Dyke Rd
Bad Axe, MI 48413-9635
Phone (248) 930-6442

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180516000990 MI Part B Supplier - Clinic/Group Practice 2365705464 Receives reassigned benefits from 2 practitioners
Practice locations: Bad Axe, MI

National Provider Directory

National Provider Directory

Locations

262 S Port Crescent St
Bad Axe, MI 48413
Phone (989) 493-9327

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1518393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747612800000",
    "number": "1235638651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 CARRIE LYNN DR",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487069399",
            "telephone_number": "248-930-6442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 S PT CRESCENT ST",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484139635",
            "telephone_number": "989-493-9327",
            "fax_number": "989-623-0172"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1080 S Van Dyke Rd",
            "address_purpose": "LOCATION",
            "city": "Bad Axe",
            "state": "MI",
            "postal_code": "484139635",
            "country_code": "US",
            "telephone_number": "248-930-6442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ROSTAM ADULT AND PEDIATRIC MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-12",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A",
        "authorized_official_last_name": "ROSTAM",
        "authorized_official_first_name": "BEHZOD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-930-6442",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bad Axe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; 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.