Organization Active NPI

Richard R Hammoud MD PC

  • Internal Medicine Physician
  • Dearborn, MI
National Provider Identifier
1568754349
Registry record updated Jul 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301078443 Issued in MI
Legal business name
RICHARD R HAMMOUD MD PC
Practice address
23865 Michigan Ave
Dearborn, MI 48124-1805
Phone
(313) 562-9588
Fax
(313) 562-9589
NPI assigned
May 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2012

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

Authorized official

Name
Dr. Richard Hammoud, MDNPI 1255330767
Title
Owner
Phone
(313) 282-7645

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 4301078443 MI Primary

Addresses

Primary practice location

23865 Michigan Ave
Dearborn, MI 48124-1805

Mailing address

23865 Michigan Ave
Dearborn, MI 48124-1805
Phone (313) 562-9588

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110808000445 MI Part B Supplier - Clinic/Group Practice 8628247772 Receives reassigned benefits from 2 practitioners
Practice locations: Dearborn, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2037038Richard Hammoud MD PC23865 Michigan Ave, Dearborn, MI 48124Certificate of waiverFeb 16, 2028

National Provider Directory

National Provider Directory

Locations

23865 Michigan Ave
Dearborn, MI 48124
Phone (313) 562-9588

Practitioners & affiliated clinicians

Practitioners 2

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": "1305072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342137600000",
    "number": "1568754349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23865 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241805",
            "telephone_number": "313-562-9588",
            "fax_number": "313-562-9589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23865 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241805",
            "telephone_number": "313-562-9588",
            "fax_number": "313-562-9589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD R HAMMOUD MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-11",
        "last_updated": "2012-07-13",
        "status": "A",
        "authorized_official_last_name": "HAMMOUD",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-282-7645",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301078443",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.