Individual provider Active NPI

Kassem M Charara, MD

  • Surgery Physician
  • Dearborn, MI
National Provider Identifier
1265412449
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
KC060523 Issued in MI
Practice address
6211 Chase Rd
Dearborn, MI 48126-2107
Phone
(313) 581-1222
Fax
(313) 581-6657
NPI assigned
Jan 23, 2006
Last updated
Jun 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X KC060523 MI Primary

Addresses

Primary practice location

6211 Chase Rd
Dearborn, MI 48126-2107

Mailing address

6211 Chase Rd
Dearborn, MI 48126-2405
Phone (313) 581-1222

Other practice location 1

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-0688

Other practice location 2

10000 Telegraph Rd
Taylor, MI 48180-3330
Phone (313) 295-5253

Other identifiers 3

IdentifierTypeStateIssuer
M18430001OtherMIMEDICARE ID
1040957460MedicaidMI
383533086OtherMICOMERCIAL

Other names 1

  • Dr. Kassem M Sharara Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kcharara112731@direct.beaumont.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20080324000488 MI Practitioner - General Surgery 0244316859 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6325 Chase Rd
Suite B
Dearborn, MI 48126-4522
Phone (313) 581-1222

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy18
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux21
Removal of tissue20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
KC060523MIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont Medical Group Hospital -Based Services CurrentSince May 9, 2023 Accepting new patients
Kassem M Charara MD PC CurrentSince Mar 24, 2008 Accepting new patients
Oakwood Youth Programs, LLC Past Accepting new patients

Locations

6211 Chase Rd
Dearborn, MI 48126
Phone (313) 581-1222

18101 Oakwood Blvd
Fl 1
Dearborn, MI 48124
Phone (313) 436-2898

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

6325 Chase Rd
Ste B
Dearborn, MI 48126
Phone (313) 581-1222

26901 Beaumont Blvd
Ste 3D
Southfield, MI 48033
Phone (947) 522-1860

10000 Telegraph Rd
Taylor, MI 48180
Phone (313) 295-5000

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

Interoperability endpoints

  • Direct secure messaging: kcharara1228553@epic00.shdirect.org
  • Direct secure messaging: kcharara112731@direct.beaumont.edu
  • Direct secure messaging: kcharara220780@direct.hfhs.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1265412449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6211 CHASE RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262405",
            "telephone_number": "313-581-1222",
            "fax_number": "313-581-6657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6211 CHASE RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262107",
            "telephone_number": "313-581-1222",
            "fax_number": "313-581-6657"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26901 Beaumont Blvd Ste 3D",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480333849",
            "country_code": "US",
            "telephone_number": "947-522-0688",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10000 Telegraph Rd",
            "address_purpose": "LOCATION",
            "city": "Taylor",
            "state": "MI",
            "postal_code": "481803330",
            "country_code": "US",
            "telephone_number": "313-295-5253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARARA",
        "first_name": "KASSEM",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "KC060523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "M18430001",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1040957460",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMERCIAL",
            "identifier": "383533086",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcharara112731@direct.beaumont.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "10000 Telegraph Rd",
            "city": "Taylor",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481803330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KASSEM",
            "last_name": "SHARARA",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.