NPIMap

Individual provider Active NPI

Ariel Andre Waitzman, M.D.

  • Otolaryngology Physician
  • Dearborn, MI
National Provider Identifier
1639149677
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
4301071017 Issued in MI
Practice address
22731 Newman Street
Ste 120
Dearborn, MI 48124
Phone
(313) 582-8853
Fax
(313) 582-6417
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 4301071017 MI Primary

Addresses

Primary practice location

22731 Newman Street
Ste 120
Dearborn, MI 48124

Mailing address

31700 Nottingham Dr
Franklin, MI 48025-1234
Phone (248) 594-6734

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Dearborn Direct

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
I20080530000723 MI Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 6709956964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22731 Newman St
Suite 120
Dearborn, MI 48124-2043
Phone (313) 582-8853

Hospital & facility affiliations

  • Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Corewell Health Wayne Hospital Hospital, Wayne, MI, CCN 230142
  • Beaumont Hospital - Taylor Hospital, Taylor, MI, CCN 230270
  • St Joe Mercy Hospital System Livonia Hospital, Livonia, MI, CCN 230002

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ariel Waitzman MD PC Otolaryngology Current Accepting new patients
Ariel Waitzman MD PLLC Otolaryngology CurrentSince Jun 12, 2001 Accepting new patients

Locations

22731 Newman St
Ste 120
Dearborn, MI 48124
Phone (313) 582-8852

16801 Newburgh Rd
Ste 106
Livonia, MI 48154
Phone (734) 367-4603

Interoperability endpoints

  • Direct secure messaging: awaitzman@dbnent.emadirect.md

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 8

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": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1639149677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31700 NOTTINGHAM DR",
            "city": "FRANKLIN",
            "state": "MI",
            "postal_code": "480251234",
            "telephone_number": "248-594-6734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22731 NEWMAN STREET",
            "address_2": "STE 120",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "48124",
            "telephone_number": "313-582-8853",
            "fax_number": "313-582-6417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAITZMAN",
        "first_name": "ARIEL",
        "middle_name": "ANDRE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "4301071017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Dearborn",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Dearborn",
            "address_1": "22731 Newman Street",
            "address_2": "Ste 120",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "48124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.