Individual provider Active NPI

Tariq Abdelrahim Faris Hammad, M.D.

  • Gastroenterology Physician
  • Detroit, MI
National Provider Identifier
1245674753
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
4301508601 Issued in MI
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

Updated by the provider on May 10, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190920002805 WV Practitioner - Gastroenterology 6507162419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Hospital Center IncGroup PAC ID 8123936010, 290 clinicians

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 Hospital, Bridgeport, WV, CCN 510006
  • West Virginia University Hospitals, Inc Hospital, Morgantown, WV, CCN 510001
  • St Joseph'S Hospital of Buckhannon, Inc Hospital, Buckhannon, WV, CCN 511321
  • Braxton County Memorial Hospital, Inc Hospital, Gassaway, WV, CCN 511308

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy136
Upper gastrointestinal (GI) endoscopy for acid reflux424

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301508601MIMDInternal Medicine Physician
28717WVMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Hospital Center, Inc. Internal Medicine CurrentSince Jul 1, 2019 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.

Hospital & facility affiliations 4

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": "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

Verify at the official NPI Registry.