Individual provider Active NPI

Adham Yassine, MD

  • Surgery Physician
  • Wyandotte, MI
National Provider Identifier
1497450076
Registry record updated Jul 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4351050941 Issued in MI
Practice address
2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone
(734) 246-6000
NPI assigned
Apr 3, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 4351050941 MI Primary

Addresses

Primary practice location

2333 Biddle Ave
Wyandotte, MI 48192-4668

Mailing address

25539 Loch Lomond Dr
Dearborn Heights, MI 48125-1031
Phone (443) 540-6416

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230502002826 MI Order and Referring Only - General SurgeryPractitioner - General Surgery 5597120287

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4351050941MIMDSurgery Physician

Interoperability endpoints

  • Direct secure messaging: ayassine847214@direct.hfhs.org

NPI Registry JSON

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690675200000",
    "number": "1497450076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25539 LOCH LOMOND DR",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481251031",
            "telephone_number": "443-540-6416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 BIDDLE AVE",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481924668",
            "telephone_number": "734-246-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YASSINE",
        "first_name": "ADHAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-07-30",
        "certification_date": "2023-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4351050941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyandotte, MI

Sources for this page

Verify at the official NPI Registry.