NPIMap

Organization Active NPI

Great Health Medical Mi PC

  • Family Medicine Physician
  • Flint, MI
National Provider Identifier
1336958792
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GREAT HEALTH MEDICAL MI PC
Practice address
3011 N Center Rd
Flint, MI 48506-3149
Phone
(718) 470-0288
NPI assigned
Dec 31, 2024
Last updated
Jun 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

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

Authorized official

Name
Azlan TariqNPI 1528291283
Title
Owner
Phone
(212) 734-6621

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Primary Care Clinic/Center 261QP2300X NU

Addresses

Primary practice location

3011 N Center Rd
Flint, MI 48506-3149

Mailing address

407 Willoughby Ave
Brooklyn, NY 11205-4590

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250211002849 MI Part B Supplier - Clinic/Group Practice 8628508355 Receives reassigned benefits from 9 practitioners
Practice locations: Flint, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1735603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781740800000",
    "number": "1336958792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 WILLOUGHBY AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112054590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 N CENTER RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485063149",
            "telephone_number": "718-470-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT HEALTH MEDICAL MI PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-31",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A",
        "authorized_official_last_name": "TARIQ",
        "authorized_official_first_name": "AZLAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-734-6621"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.