NPIMap

Organization Active NPI

Apex Behavioral Health Dearborn PLLC

  • Psychiatry Physician
  • Dearborn, MI
National Provider Identifier
1467732644
Registry record updated Aug 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
4301040442 Issued in MI
Legal business name
APEX BEHAVIORAL HEALTH DEARBORN PLLC
Practice address
6 Parklane Blvd
Suite 695
Dearborn, MI 48126-2696
Phone
(313) 271-8170
Fax
(313) 271-8353
NPI assigned
Aug 19, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2011

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

Authorized official

Name
Dr. Ghulam Qadir, MDNPI 1770662165
Title
Ceo
Phone
(313) 271-8170

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
Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0800X 4301040442 MI Primary

Addresses

Primary practice location

6 Parklane Blvd
Suite 695
Dearborn, MI 48126-2696

Mailing address

6 Parklane Blvd
Suite 695
Dearborn, MI 48126-2696
Phone (313) 271-8170

Other identifiers 9

IdentifierTypeStateIssuer
6801067821OtherMILICENSE
6801079069OtherMILICENSE
6801091642OtherMILICENSE
4301034895OtherMILICENSE
4301055604OtherMILICENSE
6301002147OtherMILICENSE
6301003906OtherMILICENSE
6801019436OtherMILICENSE
4301040442OtherMILICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120222000840 MI Part B Supplier - Clinic/Group Practice 7911165949 Receives reassigned benefits from 12 practitioners
Practice locations: Dearborn, MI

National Provider Directory

National Provider Directory
Tax ID family
Apex Behavioral Healthpllc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313798400000",
    "number": "1467732644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 PARKLANE BLVD",
            "address_2": "SUITE 695",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262696",
            "telephone_number": "313-271-8170",
            "fax_number": "313-271-8353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 PARKLANE BLVD",
            "address_2": "SUITE 695",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262696",
            "telephone_number": "313-271-8170",
            "fax_number": "313-271-8353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APEX BEHAVIORAL HEALTH DEARBORN PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-19",
        "last_updated": "2011-08-20",
        "status": "A",
        "authorized_official_last_name": "QADIR",
        "authorized_official_first_name": "GHULAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-271-8170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "4301040442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "6801067821",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "6801079069",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "6801091642",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4301034895",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4301055604",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "6301002147",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "6301003906",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "6801019436",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4301040442",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2011; 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.