Henry Ford Health System -Free Standing Clinic
Organization Active NPI Hematology & Oncology Physician · Detroit, MI
NPI 1306368923 · NPPES record last updated Aug 23, 2024
Key facts
- NPI
- 1306368923
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Hematology & Oncology Physician 207RH0003X
- Legal business name
- HENRY FORD HEALTH SYSTEM -FREE STANDING CLINIC
- Practice address
- 2799 W Grand Blvd
Detroit, MI 48202-2608 - Phone
- (313) 916-2600
- NPI assigned
- Jul 14, 2017
- Organization subpart
- No
Authorized official
- Name
- Mrs. Kelly Ratowski
- Title
- Director Provider Affairs
- Phone
- (313) 874-4806
Other NPIs on the same Medicare enrollment 28
Corporate family (same tax ID) 24
Practitioners 11
-
David S. Anderson, M.D.
-
Robert John Carroll, M.D.
-
Bojana Jovanovic, MD
-
Gazala Naaz Khan, M.D.
-
Christian G. Nageotte, M.D.
-
Daniel R. Ouellette, M.D.
-
Siyadath S. Rabbaig, M.D.
-
Yousuf A. Siddiqui, M.D.
-
Bashiruddin K Ahmad, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031105000139 | MI | Part B Supplier - Clinic/Group Practice | 0547178311 |
Receives reassigned benefits from 1,862 practitioners 28 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Novi, MI; Sterling Heights, MI; Southfield, MI; Saint Clair Shores, MI; Royal Oak, MI; Plymouth, MI; Northville, MI; Milford, MI… |
National Provider Directory
- Tax ID family
- Henry for Hospital
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | |||
| Allergy & Immunology (Internal Medicine) Physician |
207RA0201X | |||
| Cardiovascular Disease Physician |
207RC0000X | |||
| Endocrinology, Diabetes & Metabolism Physician |
207RE0101X | |||
| Gastroenterology Physician |
207RG0100X | |||
| Hematology & Oncology Physician |
207RH0003X | Yes | ||
| Nephrology Physician |
207RN0300X | |||
| Pulmonary Disease Physician |
207RP1001X | |||
| Rheumatology Physician |
207RR0500X | |||
| Sleep Medicine (Internal Medicine) Physician |
207RS0012X | |||
| Neurology Physician |
2084N0400X | |||
| Radiation Oncology Physician |
2085R0001X |
Addresses
Primary practice location
2799 W Grand Blvd
Detroit, MI 48202-2608
Mailing address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600
Other providers in Detroit, MI
- Henry Ford Health System
- Henry Ford Health System
- Henry Ford Health System
- Henry Ford Health System
- Henry Ford Health System
- Henry Ford Health System-School Based Health Initiative
- Henry Ford Health Sytems
- Henry Ford Health Sytems
- Henry Ford Health-Main Hospital
- Henry Ford Heath System
All providers in Detroit, MI · Hematology & Oncology Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.