Individual provider Active NPI

Issam S Asad, M.D.

  • General Practice Physician
  • Keego Harbor, MI
National Provider Identifier
1396941332
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
4301078808 Issued in MI
Practice address
3435 Orchard Lake Rd
Keego Harbor, MI 48320
Phone
(313) 286-3277
NPI assigned
Jun 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 4301078808 MI Primary

Addresses

Primary practice location

3435 Orchard Lake Rd
Keego Harbor, MI 48320

Mailing address

7188 White Oak Dr
West Bloomfield, MI 48323
Phone (248) 444-9044

Other identifiers 3

IdentifierTypeStateIssuer
0F317940OtherMIBCBS OF MICHIGAN
700H231390OtherMIBCBSM GROUP NUMBER
383601519OtherMITAX ID

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
I20070822000816 MI Practitioner - General Practice 6406948488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22130 Ford Rd
Dearborn, MI 48127-1539
Phone (313) 722-4447

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301078808MIMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Greenfeild Urgent Care Center Current Accepting new patients
Exclusive Physicians Group, PLLC Past Accepting new patients
Medical Visiting Physicians PLLC PastSince Nov 1, 2007 Accepting new patients
House Calls Physicians PLLC PastSince May 19, 2011 Accepting new patients
Home Health Management PC Past Accepting new patients
Keego Harbor Urgent Care Past Accepting new patients
Family Medical Care PLC PastSince May 1, 2008 Accepting new patients
Family Medical Clinic PC Past Accepting new patients

Locations

24355 Ford Rd
Dearborn, MI 48128
Phone (313) 247-8067

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1396941332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7188 WHITE OAK DR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "48323",
            "telephone_number": "248-444-9044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 ORCHARD LAKE RD",
            "city": "KEEGO HARBOR",
            "state": "MI",
            "postal_code": "48320",
            "telephone_number": "313-286-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASAD",
        "first_name": "ISSAM",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-26",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301078808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "0F317940",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM GROUP NUMBER",
            "identifier": "700H231390",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "383601519",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Keego Harbor, MI

Sources for this page

Verify at the official NPI Registry.