Active NPI
Franco L Fazzalari, M.D.
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Detroit, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- 4301056091
- Practice address
- 311 Mack Ave Ste 64100
Detroit, MI 48201-2466 - Phone
- (313) 832-0650
- Fax
- (313) 993-0447
- NPI assigned
- Sep 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 4301056091 | MI | Primary |
| Surgery Physician | 208600000X | 4301056091 | MI |
Addresses
Primary practice location
311 Mack Ave Ste 64100
Detroit, MI 48201-2466
Mailing address
311 Mack Ave Ste 64100
Detroit, MI 48201-2466
Phone (313) 832-0650
Other practice location 1
1500 E Medical Center Drive
3rd floor Cardiovascular Center Recp C
Ann Arbor, MI 48109-5864
Phone (888) 287-1082
Other practice location 2
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 898-6712
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4649218 | Medicaid | MI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ffazzalari1354508@direct.beaumont.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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Thoracic Surgery
- Education
- University of Michigan Medical School, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
28100 Grand River Ave
Farmington Hills, MI 48336-5970
3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
3601 W 13 Mile Rd Ec
Beaumont Emergency Services Ro
Royal Oak, MI 48073-6712
Phone (248) 898-5058
44201 Dequindre Rd
Troy, MI 48085-1117
Phone (248) 964-0535
44250 Dequindre Rd
Sterling Heights, MI 48314-1002
Phone (248) 964-0400
Hospital & facility affiliations
- Beaumont Home Health
- Beaumont Hospital, Troy
- Beaumont Hospital Royal Oak
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.37 of 100
- Quality
- 66.73
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.98
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary artery bypass graft (CABG) | 13 |
| Pacemaker insertion or repair | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301056091 | MI | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beaumont Medical Group- Specialty Services | Surgery | Current | Accepting new patients |
| William Beaumont Hospital | Past | Accepting new patients |
Locations
28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320
3601 W 13 Mile Rd
Royal Oak, MI 48073
44250 Dequindre Rd
Sterling Hts, MI 48314
Phone (248) 964-0400
Interoperability endpoints
- franco.fazzalari@hca4.eclinicaldirectplus.com
- ffazzalari1233244@epic00.shdirect.org
- ffazzalari1354508@direct.beaumont.edu
Organizations & group practices 2
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.
-
- Surgery Physician
- Royal Oak, MI
- NPI 1578072906
-
- General Acute Care Hospital
- Troy, MI
- NPI 1306825997
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Troy, MI
- NPI 1811461734
-
- General Acute Care Hospital
- Troy, MI
- NPI 1306825997
-
- General Acute Care Hospital
- Royal Oak, MI
- NPI 1689653305
-
- General Acute Care Hospital
- Grosse Pointe, MI
- NPI 1932396017
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603324800000",
"number": "1457458929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 MACK AVE STE 64100",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012466",
"telephone_number": "313-832-0650",
"fax_number": "313-993-0447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 MACK AVE STE 64100",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012466",
"telephone_number": "313-832-0650",
"fax_number": "313-993-0447"
}
],
"practiceLocations": [
{
"address_1": "1500 E Medical Center Drive",
"address_2": "3rd floor Cardiovascular Center Recp C",
"address_purpose": "LOCATION",
"city": "Ann Arbor",
"state": "MI",
"postal_code": "481095864",
"country_code": "US",
"telephone_number": "888-287-1082",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3601 W 13 Mile Rd",
"address_purpose": "LOCATION",
"city": "Royal Oak",
"state": "MI",
"postal_code": "480736712",
"country_code": "US",
"telephone_number": "248-898-6712",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FAZZALARI",
"first_name": "FRANCO",
"middle_name": "L",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-19",
"last_updated": "2020-10-22",
"certification_date": "2020-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "MI",
"license": "4301056091",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MI",
"license": "4301056091",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4649218",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ffazzalari1354508@direct.beaumont.edu",
"affiliation": "N",
"address_1": "3601 W 13 Mile Rd",
"city": "Royal Oak",
"state": "MI",
"country_code": "US",
"postal_code": "480736712",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.