Samuel T. Fawaz, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301084045 Issued in MI

Practice address

Trinity Health Iha Medical Group Primary Care Freedom
20206 Farmington Rd
Livonia, MI 48152

Phone

(248) 476-4724

Fax

(248) 476-7091

NPI assigned

May 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI, FL2 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

Specialty

Internal Medicine

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Iha Olma Primary Non Risk LLCGroup PAC ID 1759792799, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joe Mercy Hospital System Livonia Hospital, Livonia, MI, CCN 230002
• Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sfawaz3254788@direct.trinity-health.org
• Direct secure messaging: sfawaz1258668@adventhealth.direct-ci.com

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.

• Iha Olma Primary Non Risk LLC

  • Family Medicine Physician
  • Livonia, MI
  • NPI 1073112819
  Medicare reassignment Care Compare group NPD
• Florida Hospital Physician Group Inc

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1174955256

  Internal Medicine

  Medicare reassignment NPD
• Steward Medical Group, Inc

  • Specialist
  • Brighton, MA
  • NPI 1356654495

  FL

  Medicare reassignment NPD
• Iha Olma Primary Care Risk LLC

  • Internal Medicine Physician
  • Livonia, MI
  • NPI 1578162319
  NPD
• Iha Olma Primary Non Risk LLC

  • Family Medicine Physician
  • Livonia, MI
  • NPI 1467156927

  Internal Medicine

  NPD
• Adventhealth Primary Care Network Inc

  • Family Medicine Physician
  • Altamonte Springs, FL
  • NPI 1093493637

  Internal Medicine

  NPD
• Steward Medical Group, Inc.

  • Urology Physician
  • Cocoa, FL
  • NPI 1104367630

  Internal Medicine

  NPD
• Oakwood Group IX, LLC

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1720050917
  NPD (past)
• VMD Primary Providers Eastern Michigan, PC

  • Family Medicine Physician
  • Novi, MI
  • NPI 1336625540

  Internal Medicine

  NPD (past)
• Stewart and Stewart a Medical Corporation

  • Family Medicine Physician
  • Alhambra, CA
  • NPI 1306058565

  Internal Medicine

  NPD (past)

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

• St Joseph Mercy Hospital

  • General Acute Care Hospital
  • Ypsilanti, MI
  • NPI 1780658443
  Care Compare affiliation
• St Mary Mercy Hospital

  • General Acute Care Hospital
  • Livonia, MI
  • NPI 1790706901
  Care Compare affiliation

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1295945996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DRIVE",
            "address_2": "J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "48105",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TRINITY HEALTH IHA MEDICAL GROUP PRIMARY CARE FREEDOM",
            "address_2": "20206 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "48152",
            "telephone_number": "248-476-4724",
            "fax_number": "248-476-7091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 W 13 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "48073",
            "country_code": "US",
            "telephone_number": "248-898-7999",
            "fax_number": "248-898-0580",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17392 W 13 Mile Rd",
            "address_2": "Beaumont Beverly Hills Internal Medicine",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "MI",
            "postal_code": "480255438",
            "country_code": "US",
            "telephone_number": "248-646-8166",
            "fax_number": "248-646-8176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAWAZ",
        "first_name": "SAMUEL",
        "middle_name": "T.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2024-02-29",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME150730",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301084045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sfawaz23784@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "3601 W 13 Mile Rd",
            "city": "Royal Oak",
            "state": "MI",
            "country_code": "US",
            "postal_code": "48073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hamza Abdul Fattah, MBBS
• Joseph Paul Fava, PHARMD
• Holly Jean Favero, ACNP-BC
• Alaa Fawaz, DPM
• Diane Fawaz, BT
• Victor Fawaz, DO
• Angela Fay
• Milly Fayad
• Kaitlin Faye
• FDRS Diagnostics PLLC

• Internal Medicine Physician in Livonia, MI
• Providers in Livonia, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; 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.

Verify at the official NPI Registry.