NPIMap

Individual provider Active NPI

Mazen Al Mushref, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Grosse Pointe Woods, MI
National Provider Identifier
1356781256
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
4301114419 Issued in MI
Practice address
19251 Mack Ave Ste 333
Grosse Pointe Woods, MI 48236-2898
Phone
(313) 343-7280
Fax
(313) 343-7921
NPI assigned
Jun 25, 2013
Last updated
Nov 1, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 4301114419 MI Primary

Addresses

Primary practice location

19251 Mack Ave Ste 333
Grosse Pointe Woods, MI 48236-2898

Mailing address

38 Commerce Ave SW Apt 407
Grand Rapids, MI 49503-4143
Phone (706) 254-1512

Other practice location 1

22201 Moross Rd Ste 50
Detroit, MI 48236-2166
Phone (313) 343-7774

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
I20180710003279 MI Practitioner - Endocrinology 2567605199 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
FD Farah Mi PLLCGroup PAC ID 3971739368, 4 clinicians

Practice addresses (Care Compare)

1701 S Blvd E
Suite 190
Rochester Hills, MI 48307-6124
Phone (586) 580-0760

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301114419MIMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital CurrentSince Sep 17, 2021 Accepting new patients
Pathology Specialists of Southeast Michigan PC Current Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients
FD Farah Mi PLLC Endocrinology, Diabetes & Metabolism CurrentSince Jul 1, 2023 Accepting new patients
Henry Ford Health St. John Hospital Endocrinology, Diabetes & Metabolism CurrentSince Sep 17, 2021 Accepting new patients

Locations

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

19251 Mack Ave
Ste 333
Grosse Pointe Woods, MI 48236
Phone (313) 343-7280

22201 Moross Rd
Ste 50
Grosse Pointe Woods, MI 48236
Phone (313) 343-7774

1701 South Blvd E
Ste 150
Rochester Hills, MI 48307
Phone (248) 853-6300

1701 South Blvd E
Ste 190
Rochester Hills, MI 48307
Phone (248) 289-1509

Interoperability endpoints

  • Direct secure messaging: malmushref885477@direct.hfhs.org

Organizations & group practices 5

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1356781256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 COMMERCE AVE SW APT 407",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034143",
            "telephone_number": "706-254-1512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19251 MACK AVE STE 333",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362898",
            "telephone_number": "313-343-7280",
            "fax_number": "313-343-7921"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22201 Moross Rd Ste 50",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482362166",
            "country_code": "US",
            "telephone_number": "313-343-7774",
            "fax_number": "313-343-8747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AL MUSHREF",
        "first_name": "MAZEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-25",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MI",
            "license": "4301114419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Woods, MI

Sources for this page

Verify at the official NPI Registry.