Active NPI
Tariq Abdelrahim Faris Hammad, M.D.
- Gastroenterology Physician
- Detroit, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 4301508601
- Practice address
- 2799 W Grand Blvd # K-7
Detroit, MI 48202-2608 - Phone
- (313) 916-2405
- Fax
- (313) 916-6413
- NPI assigned
- Apr 26, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4301508601 | MI | |
| Gastroenterology Physician | 207RG0100X | 28717 | WV | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Gastroenterology Physician | 207RG0100X | 4301508601 | MI | Primary |
Addresses
Primary practice location
2799 W Grand Blvd # K-7
Detroit, MI 48202-2608
Mailing address
1 Ford PL Ste 3a
Detroit, MI 48202-3450
Other practice location 1
3000 Arlington Ave
Graduate Medical Education, MS 1050
Toledo, OH 43614-2595
Phone (419) 383-3780
Other practice location 2
3000 Arlington Ave
Graduate Medical Education, MS 1050
Toledo, OH 43614-2595
Phone (419) 383-3780
Other practice location 3
527 Medical Park Dr Ste 402
Bridgeport, WV 26330
Phone (681) 342-3690
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | thammad139113@direct.wvuhsdirect.com | Health Information Exchange (HIE) | |
| Direct Messaging Address | thammad139113@direct.wvuhsdirect.com | Health Information Exchange (HIE) | |
| Direct Messaging Address | thammad139113@direct.wvuhsdirect.com | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Gastroenterology
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
327 Medical Park Dr
Bridgeport, WV 26330-9006
Phone (681) 342-1842
527 Medical Park Dr
Bridgeport, WV 26330-9009
916 W Main St
Bridgeport, WV 26330-1651
Phone (304) 842-1034
PO Box
Suite 775
Morgantown, WV 26507-0775
Hospital & facility affiliations
- United Hospital Center, Inc
- West Virginia University Hospitals, Inc
- St Joseph'S Hospital of Buckhannon, Inc
- Braxton County Memorial Hospital, Inc
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 136 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 424 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301508601 | MI | MD | Internal Medicine Physician |
| 28717 | WV | MD | Gastroenterology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Hospital Center, Inc. | Internal Medicine | Current | Accepting new patients |
Locations
527 Medical Park Dr
Ste 402
Bridgeport, WV 26330
Phone (681) 342-3690
916 W Main St
Bridgeport, WV 26330
Phone (304) 842-1034
327 Medical Park Dr
Bridgeport, WV 26330
Phone (681) 342-1000
2673 Davisson Run Rd
Ste 303
Clarksburg, WV 26301
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Bridgeport, WV
- NPI 1760965586
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Gassaway, WV
- NPI 1356304547
-
- Critical Access Hospital
- Buckhannon, WV
- NPI 1124005061
-
- General Acute Care Hospital
- Bridgeport, WV
- NPI 1184606600
-
- General Acute Care Hospital
- Morgantown, WV
- NPI 1841271459
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683676800000",
"number": "1245674753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 FORD PL STE 3A",
"city": "DETROIT",
"state": "MI",
"postal_code": "482023450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2799 W GRAND BLVD # K-7",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022608",
"telephone_number": "313-916-2405",
"fax_number": "313-916-6413"
}
],
"practiceLocations": [
{
"address_1": "3000 Arlington Ave",
"address_2": "Graduate Medical Education, MS 1050",
"address_purpose": "LOCATION",
"city": "Toledo",
"state": "OH",
"postal_code": "436142595",
"country_code": "US",
"telephone_number": "419-383-3780",
"fax_number": "419-383-3603",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3000 Arlington Ave",
"address_2": "Graduate Medical Education, MS 1050",
"address_purpose": "LOCATION",
"city": "Toledo",
"state": "OH",
"postal_code": "436142595",
"country_code": "US",
"telephone_number": "419-383-3780",
"fax_number": "419-383-3603",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "527 Medical Park Dr Ste 402",
"address_purpose": "LOCATION",
"city": "Bridgeport",
"state": "WV",
"postal_code": "26330",
"country_code": "US",
"telephone_number": "681-342-3690",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HAMMAD",
"first_name": "TARIQ",
"middle_name": "ABDELRAHIM FARIS",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-04-26",
"last_updated": "2023-05-10",
"certification_date": "2023-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "4301508601",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "WV",
"license": "28717",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "MI",
"license": "4301508601",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "thammad139113@direct.wvuhsdirect.com",
"affiliation": "N",
"endpointDescription": "Direct Address",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "527 Medical Park Dr Ste 402",
"city": "Bridgeport",
"state": "WV",
"country_code": "US",
"postal_code": "263309010",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "thammad139113@direct.wvuhsdirect.com",
"affiliation": "N",
"endpointDescription": "Direct Address",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "527 Medical Park Dr Ste 402",
"city": "Bridgeport",
"state": "WV",
"country_code": "US",
"postal_code": "263309010",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "thammad139113@direct.wvuhsdirect.com",
"affiliation": "N",
"endpointDescription": "Direct Address",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "527 Medical Park Dr",
"city": "Bridgeport",
"state": "WV",
"country_code": "US",
"postal_code": "263309008",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 May 10, 2023; 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.
- 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.