Active NPI
Ribhi Hazin MD PC
- Internal Medicine Physician
- Detroit, MI
National Provider Identifier
1457727307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 4301097437
- Legal business name
- RIBHI HAZIN MD PC
- Practice address
- 4777 E Outer Dr Ste 1147
Detroit, MI 48234-3241 - Phone
- (734) 699-2900
- Fax
- (313) 731-0213
- NPI assigned
- Aug 14, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ribhi Hazin, MD
- Title
- Owner Provider
- Phone
- (734) 699-2900
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4301097437 | MI | Primary |
Addresses
Primary practice location
4777 E Outer Dr Ste 1147
Detroit, MI 48234-3241
Mailing address
PO Box 393
Dearborn Heights, MI 48127-0393
Phone (734) 699-2900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457727307 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150911001346 | MI | Part B Supplier - Clinic/Group Practice | 2062729833 |
Receives reassigned benefits from 7 practitioners Practice locations: Wyandotte, MI |
National Provider Directory
National Provider DirectoryLocations
7800 W Outer Dr
Detroit, MI 48235
Phone (313) 387-8800
1535 E State Fair
Highland Park, MI 48203
Phone (313) 891-2740
1620 Ford Ave
Wyandotte, MI 48192
Phone (734) 699-2900
Practitioners & affiliated clinicians
Practitioners 18
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Adult Health Nurse Practitioner
- Southfield, MI
- NPI 1326471764
MI
-
- Family Nurse Practitioner
- Detroit, MI
- NPI 1720596307
-
- Nurse Practitioner
- Houston, TX
- NPI 1629615109
-
- Physician Assistant
- Detroit, MI
- NPI 1902516040
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439510400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1573689600000",
"number": "1457727307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 393",
"city": "DEARBORN HEIGHTS",
"state": "MI",
"postal_code": "481270393",
"telephone_number": "734-699-2900",
"fax_number": "313-731-0213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4777 E OUTER DR STE 1147",
"city": "DETROIT",
"state": "MI",
"postal_code": "482343241",
"telephone_number": "734-699-2900",
"fax_number": "313-731-0213"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RIBHI HAZIN MD PC",
"organizational_subpart": "NO",
"enumeration_date": "2015-08-14",
"last_updated": "2019-11-14",
"status": "A",
"authorized_official_last_name": "HAZIN",
"authorized_official_first_name": "RIBHI",
"authorized_official_title_or_position": "OWNER PROVIDER",
"authorized_official_telephone_number": "734-699-2900",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "MI",
"license": "4301097437",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1457727307",
"state": "MI"
}
],
"endpoints": [],
"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 Nov 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.