Individual provider Active NPI

Hazem Malas, D.O.

  • Cardiovascular Disease Physician
  • Detroit, MI
National Provider Identifier
1295022424
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
34.013510 Issued in OH
Practice address
2799 W Grand Blvd
Detroit, MI 48202
Phone
(313) 916-2871
Fax
(313) 916-4513
NPI assigned
Jul 8, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101019423 MI
Cardiovascular Disease Physician 207RC0000X 5101019423 MI
Cardiovascular Disease Physician 207RC0000X 34.013510 OH Primary

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202

Mailing address

2940 N McCord Rd
Toledo, OH 43615-1753
Phone (419) 842-3000

Other practice location 1

50 N Perry St
Pontiac, MI 48342-2217
Phone (248) 338-5392

Other practice location 2

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2871

Other practice location 3

6777 W Maple Rd
West Bloomfield, MI 48322-3013
Phone (248) 325-1000

Other practice location 4

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2871

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hmalas129277@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150427002397 MI Practitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 0749423358 Reassigns benefits to 3 organizations
I20180817001996 OH Practitioner - Cardiovascular Disease (Cardiology) 0749423358 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Michigan College of Medicine and Surgery, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Northwest Ohio Cardiology Consultants LLCGroup PAC ID 4981752938, 84 clinicians

Practice addresses (Care Compare)

2940 N McCord Rd
Toledo, OH 43615-1753
Phone (419) 842-3000

770 Riverside Ave
Suite 106
Adrian, MI 49221-1465
Phone (517) 266-0525

Hospital & facility affiliations

  • Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068
  • Promedica Charles and Virginia Hickman Hospital Hospital, Adrian, MI, CCN 230005
  • Memorial Hospital Hospital, Fremont, OH, CCN 360156
  • Promedica Monroe Regional Hospital Hospital, Monroe, MI, CCN 230099
  • Bay Park Community Hospital Hospital, Oregon, OH, CCN 360259

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101019423MIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Consultants in Laboratory Medicine of Greater Toledo Current Accepting new patients
Oxford Urgent Care P L C CurrentSince Feb 21, 2015 Accepting new patients
Promedica Northwest Ohio Cardiology Consultants, LLC Cardiovascular Disease CurrentSince Aug 1, 2018 Accepting new patients
The Toledo Hospital CurrentSince Aug 11, 2018 Accepting new patients
The Toledo Hospital Internal Medicine CurrentSince Aug 11, 2018 Accepting new patients
Promedica Northwest Ohio Cardiology Consultants, LLC Cardiovascular Disease CurrentSince Aug 1, 2018 Accepting new patients
Lakeside Urgent Care, P. C. Internal Medicine Current Accepting new patients
Lakeside Urgent Care, P.C. Internal Medicine CurrentSince Feb 21, 2015 Accepting new patients
The Toledo Hospital Current Accepting new patients
Telemed Consultants PLLC Internal Medicine Past Accepting new patients

Locations

770 Riverside Ave
Ste 106
Adrian, MI 49221
Phone (517) 266-0525

44472 Hayes Rd
Clinton Twp, MI 48038
Phone (586) 412-0890

730 N Macomb St
Ste 429A
Monroe, MI 48162

72 S Washington St
Ste 102
Oxford, MI 48371
Phone (248) 236-8333

1037 Conneaut Ave
Ste 202
Bowling Green, OH 43402
Phone (419) 354-0104

501 Van Buren St
Fostoria, OH 44830
Phone (419) 435-7734

715 S Taft Ave
Ste 1
Fremont, OH 43420

1600 E Riverview Ave
Napoleon, OH 43545
Phone (260) 344-3045

2751 Bay Park Dr
Ste 305
Oregon, OH 43616
Phone (419) 690-7689

615 Fulton St
Port Clinton, OH 43452
Phone (419) 734-3131

1 Seagate
#800
Toledo, OH 43604
Phone (567) 585-1964

2142 N Cove Blvd
Toledo, OH 43606
Phone (419) 291-1111

4041 W Sylvania Ave
Ste 204
Toledo, OH 43623
Phone (419) 725-3300

2940 N McCord Rd
Toledo, OH 43615
Phone (419) 842-3000

Interoperability endpoints

  • Direct secure messaging: hmalas129277@direct.promedica.org

Organizations & group practices 10

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 7

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": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1295022424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 N MCCORD RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436151753",
            "telephone_number": "419-842-3000",
            "fax_number": "419-291-9883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48202",
            "telephone_number": "313-916-2871",
            "fax_number": "313-916-4513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 N Perry St",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "MI",
            "postal_code": "483422217",
            "country_code": "US",
            "telephone_number": "248-338-5392",
            "fax_number": "248-334-0947",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2799 W Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482022608",
            "country_code": "US",
            "telephone_number": "313-916-2871",
            "fax_number": "313-916-4513",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6777 W Maple Rd",
            "address_purpose": "LOCATION",
            "city": "West Bloomfield",
            "state": "MI",
            "postal_code": "483223013",
            "country_code": "US",
            "telephone_number": "248-325-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2799 W Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482022608",
            "country_code": "US",
            "telephone_number": "313-916-2871",
            "fax_number": "313-916-4513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALAS",
        "first_name": "HAZEM",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-08",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101019423",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "5101019423",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "34.013510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hmalas129277@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.