NPIMap

Individual provider Active NPI

Hosam Hakim, M.D

  • Hematology & Oncology Physician
  • Grosse Pointe Woods, MI
National Provider Identifier
1619228483
Registry record updated Jun 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
4301109700 Issued in MI
Practice address
19229 Mack Ave Ste 24
Grosse Pointe Woods, MI 48236-2857
Phone
(586) 884-5522
Fax
(313) 343-7840
NPI assigned
Sep 20, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125062123 IL
Hematology & Oncology Physician 207RH0003X 4301109700 MI Primary

Addresses

Primary practice location

19229 Mack Ave Ste 24
Grosse Pointe Woods, MI 48236-2857

Mailing address

19229 Mack Ave Ste 24
Grosse Pointe Woods, MI 48236-2857

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
I20170914002212 MI Practitioner - Hematology/OncologyPractitioner - Internal Medicine 9830330141 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

19229 Mack Ave
Suite 24
Grosse Pointe Woods, MI 48236-2857
Phone (313) 884-5522

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125062123ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital CurrentSince Jul 1, 2019 Accepting new patients
Henry Ford Health St. John Hospital Internal Medicine CurrentSince Jul 1, 2019 Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients
Fadi Salloum MD PC Internal Medicine CurrentSince Jul 11, 2017 Accepting new patients
Telemed Consultants PLLC Internal Medicine Past Accepting new patients

Locations

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

19229 Mack Ave
Ste 34
Grosse Pointe Woods, MI 48236
Phone (313) 647-3245

19229 Mack Ave
Ste 24
Grosse Pointe Woods, MI 48236
Phone (313) 884-5522

17900 23 Mile Rd
Ste 402
Macomb, MI 48044
Phone (586) 868-9090

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

1901 Star Batt Dr
Rochester Hills, MI 48309
Phone (248) 650-4580

1135 W University Dr
Ste 230
Rochester Hls, MI 48307
Phone (248) 824-2630

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

11885 E 12 Mile Rd
Ste 100A
Warren, MI 48093
Phone (586) 576-1615

Interoperability endpoints

  • Direct secure messaging: hhakim445293@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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1348099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560902400000",
    "number": "1619228483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19229 MACK AVE STE 24",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19229 MACK AVE STE 24",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362857",
            "telephone_number": "586-884-5522",
            "fax_number": "313-343-7840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAKIM",
        "first_name": "HOSAM",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-20",
        "last_updated": "2019-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125062123",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MI",
            "license": "4301109700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Woods, MI

Sources for this page

Verify at the official NPI Registry.