Individual provider Active NPI

Inshad Hassan Beydoun, PA

  • Medical Physician Assistant
  • Dearborn, MI
National Provider Identifier
1417995507
Registry record updated Dec 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601003140 Issued in MI
Practice address
4789 Westland St
Dearborn, MI 48126-2809
Phone
(313) 582-0217
NPI assigned
Jun 2, 2006
Last updated
Dec 30, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601003140 MI Primary

Addresses

Primary practice location

4789 Westland St
Dearborn, MI 48126-2809

Mailing address

4789 Westland St
Dearborn, MI 48126-2809
Phone (313) 582-0217

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040719000796 MI Practitioner - Physician Assistant 6305825795 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alzohaili Medical Consultants MD PCGroup PAC ID 4981516564, 18 clinicians

Practice addresses (Care Compare)

5220 Oakman Blvd
Dearborn, MI 48126-3318
Phone (313) 203-5300

5250 Auto Club Dr
Dearborn, MI 48126-4212

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601003140MIMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fatima Health Care,P.C. CurrentSince Aug 22, 2006 Accepting new patients
Wellstreet Urgent Care of Michigan PastSince Aug 6, 2023 Accepting new patients
Hammoud Medical Center PC Past Accepting new patients

Locations

22146 Ford Rd
Ste 3
Dearborn Heights, MI 48127
Phone (313) 562-9588

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262131200000",
    "number": "1417995507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4789 WESTLAND ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262809",
            "telephone_number": "313-582-0217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4789 WESTLAND ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262809",
            "telephone_number": "313-582-0217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEYDOUN",
        "first_name": "INSHAD",
        "middle_name": "HASSAN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2009-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601003140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.