Individual provider Active NPI

Sajad Zalzala, M.D.

  • Family Medicine Physician
  • Dearborn, MI
National Provider Identifier
1639311509
Registry record updated Feb 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301094339 Issued in MI
Practice address
835 Mason St Ste A250
Dearborn, MI 48124-2231
Phone
(313) 355-8657
Fax
(888) 655-7536
NPI assigned
Mar 24, 2009
Last updated
Feb 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2022

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C151483 CA
Family Medicine Physician 207Q00000X C1-0012997 DE
Family Medicine Physician 207Q00000X 66675 WI
Family Medicine Physician 207Q00000X MD046976 DC
Family Medicine Physician 207Q00000X 289619 NY
Family Medicine Physician 207Q00000X 35.129936 OH
Family Medicine Physician 207Q00000X 77333 GA
Family Medicine Physician 207Q00000X 4301094339 MI Primary

Addresses

Primary practice location

835 Mason St Ste A250
Dearborn, MI 48124-2231

Mailing address

6437 Argyle St
Dearborn, MI 48126-2136
Phone (313) 653-1790

Other practice location 1

6735 Conroy Rd
Orlando, FL 32835-3565
Phone (877) 380-1351

Other practice location 2

11211 Katy Fwy Ste 252
Houston, TX 77079-2126
Phone (877) 380-1351

Other practice location 3

18001 Sky Park Cir Ste K
Irvine, CA 92614-0506
Phone (877) 380-1351

Other practice location 4

6071 Washington St
Gurnee, IL 60031-5348
Phone (877) 380-1351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH, AZ, MA, VA, TX, IL, CO, WA, PA10 enrollments
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 10

Enrollment IDStateProvider typePAC IDDetails
I20120823000140 MI Practitioner - Family Practice 5092962209
I20200519001698 OH Practitioner - Family Practice 5092962209
I20200904000516 AZ Practitioner - Family Practice 5092962209
I20210712002717 MA Practitioner - Family Practice 5092962209
I20210805003152 VA Practitioner - Family Practice 5092962209
I20211105002031 TX Practitioner - Family Practice 5092962209 Reassigns benefits to 1 organization
I20220105002561 IL Practitioner - Family Practice 5092962209
I20220124000045 CO Practitioner - Family Practice 5092962209
I20220707002217 WA Practitioner - Family Practice 5092962209 Reassigns benefits to 1 organization
I20230104002025 PA Practitioner - Family Practice 5092962209

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD046976DCMDFamily Medicine Physician
C1-0012997DEMDFamily Medicine Physician
77333GAMDFamily Medicine Physician
4301094339MIMDFamily Medicine Physician
35.129936OHMDFamily Medicine Physician
66675WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Freeland Primary Care PLLC CurrentSince Aug 20, 2023 Accepting new patients
Howard B Miller MD Inc PS Family Medicine Current Accepting new patients
Evon Cadogan MD Inc PastSince Jul 1, 2021 Accepting new patients
Oasis Interventional Spine Care, LLC Past Accepting new patients
Truecare24 Physicians Group PC Family Medicine Past Accepting new patients

Locations

5577 Vanbarr Pl
Freeland, WA 98249
Phone (360) 320-9491

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1639311509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6437 ARGYLE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262136",
            "telephone_number": "313-653-1790",
            "fax_number": "888-655-7536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 MASON ST STE A250",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242231",
            "telephone_number": "313-355-8657",
            "fax_number": "888-655-7536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6735 Conroy Rd",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328353565",
            "country_code": "US",
            "telephone_number": "877-380-1351",
            "fax_number": "888-655-7536",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11211 Katy Fwy Ste 252",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770792126",
            "country_code": "US",
            "telephone_number": "877-380-1351",
            "fax_number": "888-655-7536",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18001 Sky Park Cir Ste K",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926140506",
            "country_code": "US",
            "telephone_number": "877-380-1351",
            "fax_number": "888-655-7536",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6071 Washington St",
            "address_purpose": "LOCATION",
            "city": "Gurnee",
            "state": "IL",
            "postal_code": "600315348",
            "country_code": "US",
            "telephone_number": "877-380-1351",
            "fax_number": "888-655-7536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZALZALA",
        "first_name": "SAJAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-24",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C151483",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C1-0012997",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "66675",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DC",
            "license": "MD046976",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "289619",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.129936",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "77333",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301094339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.