NPIMap

Individual provider Active NPI

Gregory David Hazergian, D.O.

  • Cardiovascular Disease Physician
  • Dearborn, MI
National Provider Identifier
1588923734
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
5101019695 Issued in MI
Practice address
20200 Outer Dr
Dearborn, MI 48124-2634
Phone
(313) 624-8417
NPI assigned
May 9, 2012
Last updated
Dec 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101019695 MI
Nuclear Cardiology Physician 207UN0901X 5101019695 MI
Cardiovascular Disease Physician 207RC0000X 5101019695 MI Primary

Addresses

Primary practice location

20200 Outer Dr
Dearborn, MI 48124-2634

Mailing address

1 Ford PL Ste 3a
Detroit, MI 48202-3450
Phone (313) 874-4806

Other practice location 1

3900 W 7 Mile Road
Livonia, MI 48152
Phone (734) 414-1376

Other practice location 2

40720 Ann Arbor Rd E
Plymouth, MI 48170-4447
Phone (734) 414-1376

Other practice location 3

205 N East Ave
Jackson, MI 49201-1753
Phone (517) 205-4800

Other practice location 4

19850 Gibralter Rd
Gibraltar, MI 48173
Phone (734) 301-3125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180914002459 MI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4981974888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Physician PartnersGroup PAC ID 8921482605, 79 clinicians

Practice addresses (Care Compare)

20200 Outer Dr
Dearborn, MI 48124-2634
Phone (313) 924-8417

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101019695MIMDNuclear Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Associates of Mt. Clemens, PC Internal Medicine Current Accepting new patients
Henry Ford Physician Partners Cardiovascular Disease CurrentSince Dec 1, 2024 Accepting new patients
Henry Ford Physician Partners Internal Medicine Current Accepting new patients
Henry Ford Macomb Ancillary Services Current Accepting new patients
Alliance Health Professionals, PLLC Internal Medicine Current Accepting new patients

Locations

20200 Outer Dr
Dearborn, MI 48124
Phone (313) 624-8417

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

28050 Grand River Ave
Farmington Hills, MI 48336
Phone (248) 471-8000

39000 7 Mile Rd
Ste 3800
Livonia, MI 48152
Phone (734) 414-1376

133 S Main St
Mount Clemens, MI 48043
Phone (586) 329-1880

Interoperability endpoints

  • Direct secure messaging: ghazergian268609@direct.hfhs.org

Organizations & group practices 5

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

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1336521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1588923734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-874-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20200 OUTER DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242634",
            "telephone_number": "313-624-8417"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3900 W 7 MILE ROAD",
            "address_purpose": "LOCATION",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "48152",
            "country_code": "US",
            "telephone_number": "734-414-1376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "40720 Ann Arbor Rd E",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MI",
            "postal_code": "481704447",
            "country_code": "US",
            "telephone_number": "734-414-1376",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 N East Ave",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492011753",
            "country_code": "US",
            "telephone_number": "517-205-4800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19850 GIBRALTER RD",
            "address_purpose": "LOCATION",
            "city": "GIBRALTAR",
            "state": "MI",
            "postal_code": "48173",
            "country_code": "US",
            "telephone_number": "734-301-3125",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAZERGIAN",
        "first_name": "GREGORY",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-09",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101019695",
            "primary": false
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "MI",
            "license": "5101019695",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "5101019695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.