NPIMap

Organization Active NPI

S. Talib Raza, P.C.

  • Pulmonary Disease Physician
  • Riverview, MI
National Provider Identifier
1356470355
Registry record updated Feb 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
4301088026 Issued in MI
Legal business name
S. TALIB RAZA, P.C.
Practice address
18025 Fort St
Riverview, MI 48193-7432
Phone
(734) 283-5555
Fax
(734) 283-1600
NPI assigned
Mar 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2013

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

Authorized official

Name
Mr. Syed M. Talib Raza, M.D.NPI 1235106915
Title
President
Phone
(248) 489-1759

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
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X 4301088026 MI Primary
Sleep Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0012X 4301088026 MI

Addresses

Primary practice location

18025 Fort St
Riverview, MI 48193-7432

Mailing address

29495 Parkside St
Farmington Hills, MI 48331-2668
Phone (248) 489-1759

Other identifiers 2

IdentifierTypeStateIssuer
0H27304OtherMIBLUE CROSS
1235106915MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070313000234 MI Part B Supplier - Clinic/Group Practice 9032212055 Receives reassigned benefits from 1 practitioner
Practice locations: Lathrup Village, MI; Riverview, MI; Southfield, MI; Taylor, MI

National Provider Directory

National Provider Directory

Locations

23999 Northwestern Hwy
Ste 161
Southfield, MI 48075
Phone (248) 304-1100

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360195200000",
    "number": "1356470355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29495 PARKSIDE ST",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483312668",
            "telephone_number": "248-489-1759",
            "fax_number": "734-283-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18025 FORT ST",
            "city": "RIVERVIEW",
            "state": "MI",
            "postal_code": "481937432",
            "telephone_number": "734-283-5555",
            "fax_number": "734-283-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S. TALIB RAZA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2013-02-07",
        "status": "A",
        "authorized_official_last_name": "RAZA",
        "authorized_official_first_name": "SYED",
        "authorized_official_middle_name": "M. TALIB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-489-1759",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "4301088026",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "MI",
            "license": "4301088026",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0H27304",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235106915",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; 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.