Individual provider Active NPI

Aghiad Chamdin, MD

  • Pediatrics Physician
  • Detroit, MI
National Provider Identifier
1376603407
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301066305 Issued in MI
Practice address
3901 Beaubien Blvd
Pediatric Hem Onc
Detroit, MI 48201
Phone
(313) 745-5515
Fax
(313) 745-5237
NPI assigned
Dec 11, 2006
Last updated
Jan 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301066305 MI Primary
Pediatric Hematology & Oncology Physician 2080P0207X 4301066305 MI

Addresses

Primary practice location

3901 Beaubien Blvd
Pediatric Hem Onc
Detroit, MI 48201

Mailing address

3901 Beaubien Blvd, Detroit, Mi 48201
Detroit, MI 48102
Phone (313) 745-5515

Other practice location 1

28050 Grand River Ave
Farmington Hills, MI 48336-5919
Phone (947) 521-8000

Other identifiers 1

IdentifierTypeStateIssuer
1376603407MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address achamdin96510@direct.beaumont.edu

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
I20070115000278 MI Practitioner - Hematology/OncologyPractitioner - Pediatric Medicine 8527068618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Pediatric Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University PediatriciansGroup PAC ID 9638070568, 121 clinicians

Practice addresses (Care Compare)

3901 Beaubien St
Detroit, MI 48201-2119
Phone (313) 745-5870

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatricians Pediatrics CurrentSince Sep 28, 2021 Accepting new patients
University Pediatricians Pediatrics CurrentSince Sep 28, 2021 Accepting new patients
Botsford General Hospital Pediatrics Past Accepting new patients
University Physician Group Pediatrics Past Accepting new patients
VHS Childrens Hospital of Michigan Inc Past Accepting new patients

Locations

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

3901 Beaubien St
Fl 3
Detroit, MI 48201
Phone (313) 745-5906

Interoperability endpoints

  • Direct secure messaging: achain1228455@epic00.shdirect.org
  • Direct secure messaging: achamdin96510@direct.beaumont.edu

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.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1376603407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN BLVD, DETROIT, MI 48201",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48102",
            "telephone_number": "313-745-5515",
            "fax_number": "313-745-5237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 BEAUBIEN BLVD",
            "address_2": "PEDIATRIC HEM ONC",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-745-5515",
            "fax_number": "313-745-5237"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28050 Grand River Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483365919",
            "country_code": "US",
            "telephone_number": "947-521-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAMDIN",
        "first_name": "AGHIAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301066305",
            "primary": true
        },
        {
            "code": "2080P0207X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Hematology-Oncology",
            "state": "MI",
            "license": "4301066305",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376603407",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "achamdin96510@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "28050 Grand River Ave",
            "city": "Farmington Hills",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483365919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.