NPIMap

Individual provider Active NPI

Wassim Moussa Bazzi, M.D.

  • Urology Physician
  • Dearborn, MI
National Provider Identifier
1316106537
Registry record updated Jan 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
4301104287 Issued in MI
Practice address
18100 Oakwood Blvd Ste 315
Dearborn, MI 48124-4085
Phone
(313) 271-0066
Fax
(313) 271-1047
NPI assigned
Jun 3, 2008
Last updated
Jan 25, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 4301104287 MI Primary

Addresses

Primary practice location

18100 Oakwood Blvd Ste 315
Dearborn, MI 48124-4085

Mailing address

20952 E 12 Mile Rd
Suite 200
Saint Clair Shores, MI 48081-3200
Phone (586) 771-4820

Other identifiers 1

IdentifierTypeStateIssuer
CB9133OtherMIMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140514000260 MI Practitioner - Urology 2466694237 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Wayne State University School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Michigan Institute of Urology PCGroup PAC ID 1052223492, 82 clinicians

Practice addresses (Care Compare)

130 Town Ctr Dr
Troy, MI 48084-1744

18100 Oakwood Blvd
Suite 315
Dearborn, MI 48124-4085
Phone (313) 271-0066

19117 Allen Rd
Suite a
Brownstown TWP, MI 48183-1066
Phone (734) 676-4040

20952 E 12 Mile Rd
Suite 200
Saint Clair Shores, MI 48081-3203
Phone (586) 771-4820

25500 Meadowbrook Rd
Suite 225
Novi, MI 48375-1882
Phone (248) 426-1300

29275 Northwestern Hwy
Suite 120
Southfield, MI 48034-1044
Phone 58677148202072

33014 5 Mile Rd
Livonia, MI 48154-3075
Phone (734) 261-7401

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301104287MIMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Battle Creek Hospital CurrentSince Sep 1, 2017 Accepting new patients
Bronson Methodist Hospital CurrentSince Jan 1, 2016 Accepting new patients
Alliance Physician Services of Michigan, P.C. Urology CurrentSince Jul 14, 2014 Accepting new patients
Wa Foote Memorial Hospital Inc. CurrentSince Dec 21, 2015 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Dec 21, 2015 Accepting new patients
Bronson Battle Creek Hospital CurrentSince Sep 1, 2017 Accepting new patients
W. a. Foote Memorial Hospital, Inc Current Accepting new patients
Michigan Institute of Urology PC Urology CurrentSince Jul 14, 2014 Accepting new patients

Locations

300 North Ave
Fl 2
Battle Creek, MI 49017
Phone (269) 245-5862

4441 Capital Ave SW
Battle Creek, MI 49015
Phone (269) 788-6888

18100 Oakwood Blvd
Ste 315
Dearborn, MI 48124
Phone (313) 271-0066

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

20952 E 12 Mile Rd
Ste 200
St Clr Shores, MI 48081
Phone (586) 771-4820

Organizations & group practices 8

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.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516838400000",
    "number": "1316106537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20952 E 12 MILE RD",
            "address_2": "SUITE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813200",
            "telephone_number": "586-771-4820",
            "fax_number": "586-771-6620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18100 OAKWOOD BLVD STE 315",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244085",
            "telephone_number": "313-271-0066",
            "fax_number": "313-271-1047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZZI",
        "first_name": "WASSIM",
        "middle_name": "MOUSSA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-03",
        "last_updated": "2018-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301104287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CB9133",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.