Michigan Metropolitan Dialysis, LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

E29967 Issued in MI

Legal business name

MICHIGAN METROPOLITAN DIALYSIS, LLC

Practice address

2361 Coolidge Hwy
Berkley, MI 48072-1550

Phone

(248) 642-5038

NPI assigned

Oct 16, 2014

Last updated

Jun 10, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Sami Zarouk, MD

Title

Partner

Phone

(248) 642-5038

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Listed as

Michigan Metropolitan Dialysis, L.L.C.CCN 232707

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Apr 15, 2016

Medicare certification status

ActiveFrom the Provider of Services file

Chain

Greenfield Health Systems

Dialysis stations

1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Henry Ford Health System

  • Clinical Pathology/Laboratory Medicine Physician
  • Detroit, MI
  • NPI 1336223635

  Member Of

  NPD member

Locations

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Gampala Harish Reddy, M.D.

  • Nephrology Physician
  • Troy, MI
  • NPI 1396768214

  Dialysis facility

  Care Compare affiliation Name & address match
• Radhika K Thalla, M.D

  • Nephrology Physician
  • Berkley, MI
  • NPI 1780738047

  Dialysis facility

  Care Compare affiliation Name & address match
• Sami Zarouk, M.D.

  • Nephrology Physician
  • Berkley, MI
  • NPI 1629015664

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1413417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465516800000",
    "number": "1386048577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30100 TELEGRAPH RD",
            "address_2": "SUITE 200",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254516",
            "telephone_number": "248-723-0219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2361 COOLIDGE HWY",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721550",
            "telephone_number": "248-642-5038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN METROPOLITAN DIALYSIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-16",
        "last_updated": "2016-06-10",
        "status": "A",
        "authorized_official_last_name": "ZAROUK",
        "authorized_official_first_name": "SAMI",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "248-642-5038",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "MI",
            "license": "E29967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Berkley, MI
• Providers in Berkley, MI by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.