Individual provider Active NPI

Sabreena Mazin Kammo, DO

  • Critical Care Medicine (Anesthesiology) Physician
  • Detroit, MI
National Provider Identifier
1568950681
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Anesthesiology) PhysicianTaxonomy code 207LC0200X
License
71441 Issued in MN
Practice address
4201 St. Antoine, Uhc 9C
Detroit, MI 48201
Phone
(313) 743-3000
NPI assigned
Apr 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Anesthesiology) Physician 207LC0200X 71441 MN Primary

Addresses

Primary practice location

4201 St. Antoine, Uhc 9C
Detroit, MI 48201

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other practice location 1

18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone (313) 593-7000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address skammo1665288@epic00.shdirect.org

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
I20230912000881 MI Practitioner - Anesthesiology 7214283076 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Northstar Anesthesia of Michigan III PLLCGroup PAC ID 7911325469, 561 clinicians

Practice addresses (Care Compare)

44201 Dequindre Rd
Nsa of Michigan III PLLC
Troy, MI 48085-1117
Phone (214) 687-0001

Hospital & facility affiliations

  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Beaumont Medical Group Hospital -Based Services CurrentSince Apr 1, 2025 Accepting new patients
Northstar Anesthesia of Michigan III PLLC CurrentSince Sep 7, 2023 Accepting new patients

Locations

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

3601 W 13 Mile Rd
Royal Oak, MI 48073

44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255

33155 Annapolis St
Wayne, MI 48184
Phone (734) 467-4042

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1568950681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 ST. ANTOINE, UHC 9C",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-743-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18101 Oakwood Blvd",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481244089",
            "country_code": "US",
            "telephone_number": "313-593-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMMO",
        "first_name": "SABREENA",
        "middle_name": "MAZIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-24",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "MN",
            "license": "71441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skammo1665288@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "18101 Oakwood Blvd",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481244089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.