Active NPI
Waddah Maskoun, M.D.
- Clinical Cardiac Electrophysiology Physician
- Detroit, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Cardiac Electrophysiology Physician
- License
- E-8285
- Practice address
- 2799 W Grand Blvd
Detroit, MI 48202-2608 - Phone
- (313) 916-2417
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician | 208M00000X | 51037 | WI | |
| Clinical Cardiac Electrophysiology Physician | 207RC0001X | E-8285 | AR | Primary |
Addresses
Primary practice location
2799 W Grand Blvd
Detroit, MI 48202-2608
Mailing address
2799 W Grand Blvd
Detroit, MI 48202-2608
Other practice location 1
4301 W Markham St
Slot 783
Little Rock, AR 72205-7101
Phone (501) 686-8000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01061491A | Other | IN | LICENSE |
| 51037-020 | Other | WI | STATE LICENSE |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone (586) 263-2300
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600
Hospital & facility affiliations
- Henry Ford Health Hospital
- Henry Ford Health West Bloomfield Hospital
- Henry Ford Macomb Hospital
- Wyandotte Hospital and Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Pacemaker insertion or repair | 39 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51037 | WI | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Health System | Current | Accepting new patients | |
| Henry Ford Health System | Current | Accepting new patients | |
| Henry Ford Macomb Hospital Corporation | Current | Accepting new patients | |
| Henry Ford Macomb Hospital Corporation | Current | Accepting new patients | |
| Henry Ford Health System | Cardiovascular Disease | Current | Accepting new patients |
| Johnson Memorial Hospital | Hospitalist | Past | Accepting new patients |
| The Medical College of Wisconsin, Inc. | Past | Accepting new patients |
Locations
16151 19 Mile Rd
Ste 215
Clinton Twp, MI 48038
Phone (586) 263-2300
15855 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-2300
15717 15 Mile Rd
Clinton Twp, MI 48035
Phone (586) 285-3800
1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953
2799 W Grand Blvd
#K14
Detroit, MI 48202
Phone (313) 916-2695
2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062
3500 15 Mile Rd
Sterling Hts, MI 48310
Phone (586) 977-9300
6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000
2333 Biddle Ave
Wyandotte, MI 48192
Phone (734) 246-6000
Interoperability endpoints
- wmaskoun440176@direct.hfhs.org
Organizations & group practices 7
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.
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1134144801
-
- Family Medicine Physician
- Clinton TWP, MI
- NPI 1134265986
-
- Community/Retail Pharmacy
- Plymouth, MI
- NPI 1942931720
-
- Cardiovascular Disease Physician
- Detroit, MI
- NPI 1982787487
-
- General Acute Care Hospital
- Clinton TWP, MI
- NPI 1023114634
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1699720086
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Detroit, MI
- NPI 1134144801
-
- General Acute Care Hospital
- West Bloomfield, MI
- NPI 1407867559
-
- General Acute Care Hospital
- Clinton TWP, MI
- NPI 1023114634
-
- General Acute Care Hospital
- Warren, MI
- NPI 1902842735
-
- Ambulatory Surgical Clinic/Center
- Wyandotte, MI
- NPI 1093901035
Hospital
-
- General Acute Care Hospital
- Wyandotte, MI
- NPI 1992725352
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1295836211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2799 W GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022608"
},
{
"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": "482022608",
"telephone_number": "313-916-2417"
}
],
"practiceLocations": [
{
"address_1": "4301 W Markham St",
"address_2": "Slot 783",
"address_purpose": "LOCATION",
"city": "Little Rock",
"state": "AR",
"postal_code": "722057101",
"country_code": "US",
"telephone_number": "501-686-8000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MASKOUN",
"first_name": "WADDAH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "WI",
"license": "51037",
"primary": false
},
{
"code": "207RC0001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
"state": "AR",
"license": "E-8285",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "01061491A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "51037-020",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.