Individual provider Active NPI

Ali Jamal Bazzi, DO

  • Pediatrics Physician
  • Dearborn, MI
National Provider Identifier
1407476039
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
5101026771 Issued in MI
Practice address
18181 Oakwood Blvd Ste 401
Dearborn, MI 48124-5031
Phone
(313) 593-7240
NPI assigned
Apr 23, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 5101026771 MI Primary

Addresses

Primary practice location

18181 Oakwood Blvd Ste 401
Dearborn, MI 48124-5031

Mailing address

26901 Beaumont Blvd
Southfield, MI 48033-3849

Other practice location 1

4201 Saint Antoine St
Uhc 9C
Detroit, MI 48201
Phone (313) 745-5146

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address abazzi5877301@direct.beaumon.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
I20230724002204 MI Practitioner - Pediatric Medicine 1355762568 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Oakwood Ambulatory, LLC CurrentSince Jul 31, 2023 Accepting new patients
Oakwood Ambulatory LLC Pediatrics CurrentSince Jul 31, 2023 Accepting new patients
Oakwood Healthcare, Inc. Past Accepting new patients
DMC Education & Research PastSince Apr 1, 2020 Accepting new patients

Locations

201 3rd St
Ste 200
Belleville, MI 48111
Phone (734) 697-9065

18181 Oakwood Blvd
Ste 401
Dearborn, MI 48124
Phone (313) 593-7240

26901 Beaumont Blvd
Southfield, MI 48033
Phone (947) 522-1867

Interoperability endpoints

  • Direct secure messaging: abazzi1224892@epic00.shdirect.org

Organizations & group practices 4

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": "1587600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1407476039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18181 OAKWOOD BLVD STE 401",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481245031",
            "telephone_number": "313-593-7240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 Saint Antoine St",
            "address_2": "UHC 9C",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "48201",
            "country_code": "US",
            "telephone_number": "313-745-5146",
            "fax_number": "313-966-0880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAZZI",
        "first_name": "ALI",
        "middle_name": "JAMAL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-23",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101026771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abazzi5877301@direct.beaumon.edu",
            "affiliation": "N",
            "address_1": "18181 Oakwood Blvd Ste 401",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481245031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.