Organization Active NPI

Ghaleb F Hatem, MD, PC

  • Ophthalmology Physician
  • Dearborn Heights, MI
National Provider Identifier
1528244647
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4301040489 Issued in MI
Legal business name
GHALEB F HATEM, MD, PC
Practice address
4655 S Telegraph Rd
Dearborn Heights, MI 48125-1936
Phone
(313) 295-2888
Fax
(313) 295-7923
NPI assigned
Jan 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

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

Authorized official

Name
Dr. Ghaleb F Hatem, M.D.NPI 1679525216
Title
Owner
Phone
(313) 295-2888

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 4301040489 MI Primary

Addresses

Primary practice location

4655 S Telegraph Rd
Dearborn Heights, MI 48125-1936

Mailing address

4655 S Telegraph Rd
Dearborn Heights, MI 48125-1936
Phone (313) 295-2888

Other identifiers 1

IdentifierTypeStateIssuer
1400778MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100820000130 MI Part B Supplier - Clinic/Group Practice 6002940459 Receives reassigned benefits from 1 practitioner
Practice locations: Dearborn Heights, MI

National Provider Directory

National Provider Directory

Locations

4655 S Telegraph Rd
Dearborn Hts, MI 48125
Phone (313) 295-2888

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201564800000",
    "number": "1528244647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 S TELEGRAPH RD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481251936",
            "telephone_number": "313-295-2888",
            "fax_number": "313-295-7923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4655 S TELEGRAPH RD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481251936",
            "telephone_number": "313-295-2888",
            "fax_number": "313-295-7923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GHALEB F HATEM, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-18",
        "last_updated": "2008-01-29",
        "status": "A",
        "authorized_official_last_name": "HATEM",
        "authorized_official_first_name": "GHALEB",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-295-2888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301040489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1400778",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; 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.