Bardia Gholami, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

4301086885 Issued in MI

Practice address

3901 Chrysler Dr FL 3
Detroit, MI 48201

Phone

(313) 577-1396

Fax

(313) 577-1419

NPI assigned

Mar 9, 2007

Last updated

May 17, 2018By the provider in NPPES

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

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mynd Thera PLLCGroup PAC ID 2062937964, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mynd Thera PLLC

  dba Mynd Horizon - Detroit

  • Psychiatry Physician
  • Grosse Pointe Woods, MI
  • NPI 1255146965
  Medicare reassignment Care Compare group NPD
• Neighborhood Service Organization

  • Community/Behavioral Health Agency
  • Detroit, MI
  • NPI 1891825808
  Medicare reassignment NPD
• University Physician Group

  dba Wayne Health

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1447299797
  Medicare reassignment NPD
• Wayne County Treasurer-Payroll County of Wayne

  • Federally Qualified Health Center (FQHC)
  • Hamtramck, MI
  • NPI 1700215977
  Medicare reassignment NPD
• Wayne County Treasurer Payroll-County of Wayne

  • Federally Qualified Health Center (FQHC)
  • Wayne, MI
  • NPI 1538543160
  NPD

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526515200000",
    "number": "1316079270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3587 CENTURY TRL",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481976172",
            "telephone_number": "734-709-3757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 CHRYSLER DR FL 3",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-577-1396",
            "fax_number": "313-577-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHOLAMI",
        "first_name": "BARDIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2018-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "390200000X",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301086885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachad Ghazal, MD
• Petra Gheraibeh, MD
• Jennifer C Gherasim, CRNA
• Marisa Lynn Ghesquiere, MSN, RN
• Bipin Ghimire, MBBS
• Angela Gholston
• Erica Gholston
• Fatemeh Ghoreishi, RPH
• Chandrani Ghosh
• Sharmila Ghosh, MD

• Psychiatry Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Psychiatry Physician in Michigan

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

Verify at the official NPI Registry.