Individual provider Active NPI

Abdallah Zamaria, M.D.

  • Psychiatry Physician
  • St Clair Shores, MI
National Provider Identifier
1346227022
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301034941 Issued in MI
Practice address
24001 Greater Mack Ave
Suite C
St Clair Shores, MI 48080-1407
Phone
(586) 772-3246
Fax
(586) 772-8550
NPI assigned
Dec 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 4301034941 MI Primary

Addresses

Primary practice location

24001 Greater Mack Ave
Suite C
St Clair Shores, MI 48080-1407

Mailing address

24001 Greater Mack Ave
Suite C
St Clair Shores, MI 48080-1407
Phone (586) 772-3246

Other identifiers 1

IdentifierTypeStateIssuer
382479136OtherMITAX ID

Other names 1

  • Dr. Barbara Henike Professional name

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120126000462 MI Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 0143253997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Geriatric Psychiatry
Education
Other, 1973
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

24001 Greater Mack Ave
Suite C
Saint Clair Shores, MI 48080-1471

24001 Greater Mack Ave C
Saint Clair Shores, MI 48080-1471

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Abdallah E Zamaria MD and Barbara Henike MD PC Psychiatry CurrentSince May 1, 1985 Accepting new patients

Locations

27739 Jefferson Ave
Ste 102
Saint Clair Shores, MI 48081
Phone (586) 772-3244

24001 Greater Mack Ave
Ste C
St Clr Shores, MI 48080
Phone (586) 772-3244

Interoperability endpoints

  • Direct secure messaging: azamaria1158612@direct.hfhs.org

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1346227022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24001 GREATER MACK AVE",
            "address_2": "SUITE C",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801407",
            "telephone_number": "586-772-3246",
            "fax_number": "586-772-8550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24001 GREATER MACK AVE",
            "address_2": "SUITE C",
            "city": "ST CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801407",
            "telephone_number": "586-772-3246",
            "fax_number": "586-772-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAMARIA",
        "first_name": "ABDALLAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301034941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "382479136",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BARBARA",
            "last_name": "HENIKE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in St Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.