Organization Active NPI

Ribhi Hazin MD PC

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1457727307
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301097437 Issued in MI
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
Last updated
Nov 14, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

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

Authorized official

Name
Ribhi Hazin, MDNPI 1265747463
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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1457727307MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150911001346 MI Part B Supplier - Clinic/Group Practice 2062729833 Receives reassigned benefits from 7 practitioners
Practice locations: Wyandotte, MI

National Provider Directory

National Provider Directory

Locations

4777 E Outer Dr
Ste 1147
Detroit, MI 48234
Phone (313) 826-6100

9500 Grand River Ave
Detroit, MI 48204
Phone (313) 491-7920

3611 Carpenter St
Hamtramck, MI 48212
Phone (313) 733-8286

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, and the practitioner matching its NPPES authorized official.

View all 18

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": "",
            "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.

Verify at the official NPI Registry.