Advanced Pulmonary & Sleep Associates PC

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

4301067420 Issued in MI

Legal business name

ADVANCED PULMONARY & SLEEP ASSOCIATES PC

Practice address

1110 N Telegraph Rd
Dearborn, MI 48124-1634

Phone

(313) 294-5400

Fax

(313) 294-5401

NPI assigned

Jul 1, 2008

Last updated

Nov 26, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ihab M Deebajah, MDNPI 1205807260

Title

Owner

Phone

(313) 333-6733

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 5

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.

• Ihab Mohammed Deebajah, MD

  • Pulmonary Disease Physician
  • Garden City, MI
  • NPI 1205807260
  Medicare reassignment Authorized official
• Thomas R Gravelyn, M.D.

  • Sleep Medicine (Internal Medicine) Physician
  • Ypsilanti, MI
  • NPI 1760442636

  Pulmonary Disease

  NPD (past)
• Mohamad Hazem Raslan, M.D

  • Pulmonary Disease Physician
  • Canton, MI
  • NPI 1619938768
  NPD (past)
• Yevgeniy G Stefadu, M.D., PH.D

  • Sleep Medicine (Internal Medicine) Physician
  • Sterling HTS, MI
  • NPI 1316913270
  NPD (past)
• Mark R. Villeneuve, MD

  • Pulmonary Disease Physician
  • Livonia, MI
  • NPI 1023054772
  NPD (past)

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

{
    "created_epoch": "1214870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574726400000",
    "number": "1487816419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 N TELEGRAPH RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281203",
            "telephone_number": "313-294-5400",
            "fax_number": "313-294-5401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 N TELEGRAPH RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241634",
            "telephone_number": "313-294-5400",
            "fax_number": "313-294-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PULMONARY & SLEEP ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-01",
        "last_updated": "2019-11-26",
        "status": "A",
        "authorized_official_last_name": "DEEBAJAH",
        "authorized_official_first_name": "IHAB",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-333-6733",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "4301067420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "290H242810",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROCARE",
            "identifier": "82027712",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "1109501061",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "DN8728",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDWEST HEALTH PLAN",
            "identifier": "026029",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "1109500421",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "1109500421",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1109501061",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN GROUP",
            "identifier": "290H242810",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Advanced Physician Group PLLC
• Advanced Surgery Center LLC
• Advanced Urogynecology of Michigan, P.C.
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• Sindhoora Adyanthaya, MD
• Nada Aezah

• Pulmonary Disease Physician in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Pulmonary Disease Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.