Individual provider Active NPI

Mohammed Mushtaq Ahmed Hakim

  • Pain Medicine (Anesthesiology) Physician
  • Jackson, MI
National Provider Identifier
1275152159
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
4301514464 Issued in MI
Practice address
205 N East Ave
Jackson, MI 49201-1753
Phone
(517) 205-7836
NPI assigned
Apr 10, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 4301514464 MI
Pain Medicine (Anesthesiology) Physician 207LP2900X 4301514464 MI Primary

Addresses

Primary practice location

205 N East Ave
Jackson, MI 49201-1753

Mailing address

451 E Town St Apt 209
Columbus, OH 43215-4724
Phone (614) 680-2552

Other practice location 1

410 W 10th Ave
Columbus, OH 43210-1240
Phone (614) 680-2552

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
I20250605001786 MI Practitioner - Anesthesiology 3870002231 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians
W. a. Foote Memorial Hospital, Inc.Group PAC ID 0244136067, 476 clinicians

Practice addresses (Care Compare)

19401 Hubbard Dr
Dearborn, MI 48126-2641
Phone (313) 982-8100

205 N E Ave
Jackson, MI 49201-1753
Phone (517) 205-4800

Hospital & facility affiliations

  • Henry Ford Health Hospital Hospital, Detroit, MI, CCN 230053
  • Henry Ford Allegiance Health Hospital, Jackson, MI, CCN 230092

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301514464MIMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince May 1, 2025 Accepting new patients
Henry Ford Pathology Current Accepting new patients
Henry Ford Health System Current Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince May 1, 2025 Accepting new patients
Wa Foote Memorial Hospital Inc Pain Medicine CurrentSince May 1, 2025 Accepting new patients
Henry Ford Health System Anesthesiology CurrentSince May 1, 2025 Accepting new patients
W. a. Foote Memorial Hospital, Inc Current Accepting new patients
Henry Ford Health System Current Accepting new patients

Locations

19401 Hubbard Dr
Dearborn, MI 48126
Phone (313) 982-8100

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

Interoperability endpoints

  • FHIR API: https://fhir.hfhs.org/FHIRProxy/api/FHIR/R4/

Organizations & group practices 8

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 2

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": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1275152159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 E TOWN ST APT 209",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432154724",
            "telephone_number": "614-680-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N EAST AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011753",
            "telephone_number": "517-205-7836"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 W 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101240",
            "country_code": "US",
            "telephone_number": "614-680-2552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUSHTAQ AHMED HAKIM",
        "first_name": "MOHAMMED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-10",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "4301514464",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MI",
            "license": "4301514464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.