Organization Active NPI

Tarif Mustafa MD PC

  • Internal Medicine Physician
  • Dearborn, MI
National Provider Identifier
1255522090
Registry record updated Oct 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
TARIF MUSTAFA MD PC
Practice address
12940 W Warren Ave
Dearborn, MI 48126-1535
Phone
(313) 945-8210
NPI assigned
Aug 7, 2007
Last updated
Oct 13, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2010

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

Authorized official

Name
Tarif MustafaNPI 1902870470
Title
MD
Phone
(313) 945-8210

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

12940 W Warren Ave
Dearborn, MI 48126-1535

Mailing address

12940 W Warren Ave
Dearborn, MI 48126-1535
Phone (313) 945-8210

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101020000129 MI Part B Supplier - Clinic/Group Practice 8628261872 Receives reassigned benefits from 3 practitioners
Practice locations: Dearborn, MI

National Provider Directory

National Provider Directory

Locations

12940 W Warren Ave
Dearborn, MI 48126
Phone (313) 846-1660

Practitioners & affiliated clinicians

Practitioners 4

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": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286928000000",
    "number": "1255522090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12940 W WARREN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261535",
            "telephone_number": "313-945-8210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12940 W WARREN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261535",
            "telephone_number": "313-945-8210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TARIF MUSTAFA MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2010-10-13",
        "status": "A",
        "authorized_official_last_name": "MUSTAFA",
        "authorized_official_first_name": "TARIF",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "313-945-8210"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; 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.