Organization Active NPI

Eastpointe Family Physicians

  • Family Medicine Physician
  • Eastpointe, MI
National Provider Identifier
1609966670
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
EASTPOINTE FAMILY PHYSICIANS
Practice address
24901 Kelly Rd
Eastpointe, MI 48021-1367
Phone
(586) 772-9055
Fax
(586) 772-0543
NPI assigned
Oct 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mr. Hardik M Shah, D.O.NPI 1508852765
Title
President/ Owner
Phone
(586) 772-9055

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 204C00000X 5101010763 MI
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X MI Primary

Addresses

Primary practice location

24901 Kelly Rd
Eastpointe, MI 48021-1367

Mailing address

24901 Kelly Rd
Eastpointe, MI 48021-1367
Phone (586) 772-9055

Other identifiers 3

IdentifierTypeStateIssuer
3439691MedicaidMI
4653079MedicaidMI
4665525MedicaidMI

National Provider Directory

National Provider Directory

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": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1609966670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24901 KELLY RD",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480211367",
            "telephone_number": "586-772-9055",
            "fax_number": "586-772-0543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24901 KELLY RD",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480211367",
            "telephone_number": "586-772-9055",
            "fax_number": "586-772-0543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTPOINTE FAMILY PHYSICIANS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "HARDIK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/ OWNER",
        "authorized_official_telephone_number": "586-772-9055",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "MI",
            "license": "5101010763",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3439691",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4653079",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4665525",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastpointe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.