NPIMap

Organization Active NPI

Hazel Park Primary Care LLC

Doing business as Neu Hope

  • Family Medicine Physician
  • Hazel Park, MI
National Provider Identifier
1306407440
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HAZEL PARK PRIMARY CARE LLC
Doing business as
Neu Hope
Practice address
624 E 9 Mile Rd Ste B
Hazel Park, MI 48030-1842
Phone
(248) 629-7497
Fax
(248) 397-8474
NPI assigned
Jun 27, 2019
Last updated
Aug 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Authorized official

Name
Mohamed G Saleh, MDNPI 1861566598
Title
President
Phone
(248) 629-7497

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Addiction Medicine (Preventive Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083A0300X

Addresses

Primary practice location

624 E 9 Mile Rd Ste B
Hazel Park, MI 48030-1842

Mailing address

PO Box 365
Hazel Park, MI 48030-0365
Phone (248) 629-7497

Other practice location 1

704 E 9 Mile Rd
Hazel Park, MI 48030-1841
Phone (248) 439-9930

Other practice location 2

15450 Northline Rd Ste 101
Southgate, MI 48195-2490
Phone (734) 225-1315

Other names 1

  • Neu Hope Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190917000580 MI Part B Supplier - Clinic/Group Practice 2961731997 Receives reassigned benefits from 13 practitioners
Practice locations: Hazel Park, MI; Southgate, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2179760Hazel Park Primary Care704 E 9 Mile Suite 100, Hazel Park, MI 48030AccreditationSep 9, 2026
23D2278268Hazel Park Primary Care15450 Northline Road Suite 101, Southgate, MI 48195Certificate of waiverMar 13, 2027
23D2278695Hazel Park Primary Care624 E 9 Mile Road Suite B, Hazel Park, MI 48030Certificate of waiverMar 21, 2027

National Provider Directory

National Provider Directory

Locations

6245 Inkster Rd
Ste 304
Garden City, MI 48135
Phone (734) 458-3300

624 E 9 Mile Rd
Ste B
Hazel Park, MI 48030
Phone (248) 629-7497

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691971200000",
    "number": "1306407440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 365",
            "city": "HAZEL PARK",
            "state": "MI",
            "postal_code": "480300365",
            "telephone_number": "248-629-7497",
            "fax_number": "248-397-8474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 E 9 MILE RD STE B",
            "city": "HAZEL PARK",
            "state": "MI",
            "postal_code": "480301842",
            "telephone_number": "248-629-7497",
            "fax_number": "248-397-8474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "704 E 9 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Hazel Park",
            "state": "MI",
            "postal_code": "480301841",
            "country_code": "US",
            "telephone_number": "248-439-9930",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15450 Northline Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Southgate",
            "state": "MI",
            "postal_code": "481952490",
            "country_code": "US",
            "telephone_number": "734-225-1315",
            "fax_number": "877-892-4080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HAZEL PARK PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-27",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A",
        "authorized_official_last_name": "SALEH",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-629-7497",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neu Hope",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hazel Park, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.