North Oakland Gastroenterology Clinic PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

KB063477 Issued in MI

Legal business name

NORTH OAKLAND GASTROENTEROLOGY CLINIC PC

Practice address

75 Barclay Circle
Suite 205
Rochester Hills, MI 48307-0020

Phone

(248) 844-2700

Fax

(248) 852-0806

NPI assigned

May 1, 2007

Organization subpart

Yes

Parent organization

NORTH OAKLAND GASTROENTEROLOGY CLINIC, PCAs reported in NPPES

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

Authorized official

Name

Dr. Kambiz Bral, MDNPI 1568452928

Title

Medical Doctor

Phone

(248) 844-2700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Premier Pathology (DBA) Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Tax ID family

North Oakland Gastro CLN PC2 organizations share this tax ID, including this one

Part of

North Oakland Gastro CLN PC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• North Oakland Gastroenterology Clinic PC

  • Clinical Medical Laboratory
  • Rochester Hills, MI
  • NPI 1215253216
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• North Oakland Gastroenterology Clinic PC

  • Clinical Medical Laboratory
  • Rochester Hills, MI
  • NPI 1215253216
  NPPES parent name

Practitioners 6

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

• Kambiz Bral, MD

  • Gastroenterology Physician
  • Rochester Hills, MI
  • NPI 1568452928
  Medicare reassignment Care Compare group NPD Authorized official
• Rafic Beydoun, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Detroit, MI
  • NPI 1831455138
  Medicare reassignment Care Compare group NPD
• Faisal Qureshi, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Detroit, MI
  • NPI 1134167208
  Medicare reassignment Care Compare group NPD
• Wael Assad Sakr, MD

  • Anatomic Pathology Physician
  • Detroit, MI
  • NPI 1033156633
  Medicare reassignment Care Compare group NPD
• Shashi K Madan, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Detroit, MI
  • NPI 1851338842
  Medicare reassignment NPD
• Michael Kam, MD

  • Gastroenterology Physician
  • Rochester Hills, MI
  • NPI 1316040504
  NPD (past)

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431475200000",
    "number": "1376764019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 81087",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483081087",
            "telephone_number": "248-844-2700",
            "fax_number": "248-852-0806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 BARCLAY CIRCLE",
            "address_2": "SUITE 205",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483070020",
            "telephone_number": "248-844-2700",
            "fax_number": "248-852-0806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH OAKLAND GASTROENTEROLOGY CLINIC PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH OAKLAND GASTROENTEROLOGY CLINIC, PC",
        "enumeration_date": "2007-05-01",
        "last_updated": "2015-05-13",
        "status": "A",
        "authorized_official_last_name": "BRAL",
        "authorized_official_first_name": "KAMBIZ",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "248-844-2700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "KB063477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306300410",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Pathology (DBA)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialist in Rochester Hills, MI
• Providers in Rochester Hills, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2015; 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.