Individual provider Active NPI

Samer J Bahu, MD

  • Otolaryngology Physician
  • Pontiac, MI
National Provider Identifier
1366547143
Registry record updated Jan 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
4301068016 Issued in MI
Practice address
44200 Woodward Ave
Suite 201
Pontiac, MI 48341-2985
Phone
(248) 334-9490
Fax
(248) 636-1170
NPI assigned
Sep 14, 2006
Last updated
Jan 25, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 4301068016 MI Primary

Addresses

Primary practice location

44200 Woodward Ave
Suite 201
Pontiac, MI 48341-2985

Mailing address

44200 Woodward Ave
Suite 201
Pontiac, MI 48341-2985
Phone (248) 334-9490

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, HI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120210000457 MI Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 8325205875 Reassigns benefits to 1 organization
I20241212003260 HI Practitioner - Otolaryngology 8325205875 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Wayne State University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hawaii Ear Nose and Throat Consultants CorpGroup PAC ID 4486663119, 5 clinicians
Michigan Ear Nose and Throat Associates PCGroup PAC ID 9133299654, 3 clinicians

Practice addresses (Care Compare)

1441 Kapiolani Blvd
Suite 1300
Honolulu, HI 96814-4489
Phone (808) 951-4900

44200 Woodward Ave
201 Michigan Ear Nose and Throat
Pontiac, MI 48341-5045
Phone (248) 334-9490

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
7.5 of 100Reported as individual
Quality
15
Improvement activities
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision19
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hawaii Ear Nose and Throat Consultants Corp Otolaryngology CurrentSince Nov 4, 2024 Accepting new patients
Bashar Succar MD PC CurrentSince Nov 14, 2011 Accepting new patients

Locations

98-1247 Kaahumanu St
Ste 222
Aiea, HI 96701
Phone (808) 484-7907

1441 Kapiolani Blvd
Ste 1300
Honolulu, HI 96814
Phone (808) 951-4900

44200 Woodward Ave
Ste 201
Pontiac, MI 48341
Phone (248) 334-9490

Interoperability endpoints

  • Direct secure messaging: sambahumd@michiganent.ssdirect.aprima.com
  • Direct secure messaging: sbahu37604@direct.trinity-health.org

Organizations & group practices 3

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 3

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295913600000",
    "number": "1366547143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44200 WOODWARD AVE",
            "address_2": "SUITE 201",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483412985",
            "telephone_number": "248-334-9490",
            "fax_number": "248-636-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44200 WOODWARD AVE",
            "address_2": "SUITE 201",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483412985",
            "telephone_number": "248-334-9490",
            "fax_number": "248-636-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHU",
        "first_name": "SAMER",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2011-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "4301068016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.