NPIMap

Individual provider Active NPI

Emad Daher, MD

  • Internal Medicine Physician
  • Port Huron, MI
National Provider Identifier
1265415285
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301076169 Issued in MI
Practice address
1210 10TH Ave
Port Huron, MI 48060-3406
Phone
(810) 662-3505
Fax
(810) 662-3479
NPI assigned
Nov 23, 2005
Last updated
Feb 12, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301076169 MI Primary

Addresses

Primary practice location

1210 10TH Ave
Port Huron, MI 48060-3406

Mailing address

1210 10TH Ave
Port Huron, MI 48060-3406
Phone (810) 662-3505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040901000234 MI Practitioner - Internal Medicine 8022083104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Water Internal Medicine PCGroup PAC ID 3577994490, 4 clinicians

Practice addresses (Care Compare)

1210 10TH Ave
Port Huron, MI 48060-3406
Phone (810) 662-3505

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301076169MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Water Internal Medicine, PC Internal Medicine CurrentSince Apr 28, 2020 Accepting new patients
Regency on the Lake-Fort Gratiot, LLC Past Accepting new patients
Port Huron Internal Medicine Past Accepting new patients
Marwood Manor Nursing Home Past Accepting new patients
Port Huron Opco LLC Past Accepting new patients
McLaren Port Huron Past Accepting new patients

Locations

1210 10th Ave
Port Huron, MI 48060
Phone (810) 662-3505

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BIGACD

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
McLaren Port HuronPort Huron, MI, CCN 230216 Hospital Corporate Director Apr 23, 2026
McLaren Port HuronPort Huron, MI, CCN 23S216 Hospital Corporate Director Mar 24, 2026

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1265415285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 10TH AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603406",
            "telephone_number": "810-662-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 10TH AVE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603406",
            "telephone_number": "810-662-3505",
            "fax_number": "810-662-3479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHER",
        "first_name": "EMAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301076169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.