NPIMap

Organization Active NPI

Cedar Medical Associates

  • Internal Medicine Physician
  • Dearborn, MI
National Provider Identifier
1649451964
Registry record updated Apr 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
GG078483 Issued in MI
Legal business name
CEDAR MEDICAL ASSOCIATES
Practice address
1951 Monroe St
Dearborn, MI 48124-2916
Phone
(313) 563-5757
Fax
(313) 563-5760
NPI assigned
Nov 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2017

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

Authorized official

Name
Dr. Ghadi G Ghorayeb, MDNPI 1932158425
Title
Owner
Phone
(313) 563-5757

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
Phlebology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 202K00000X GG078483 MI
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X GG078483 MI Primary

Addresses

Primary practice location

1951 Monroe St
Dearborn, MI 48124-2916

Mailing address

1951 Monroe St
Dearborn, MI 48124-2916
Phone (313) 563-5757

Other identifiers 2

IdentifierTypeStateIssuer
110H232600OtherMIBCN
110H232600OtherMIBC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080213000636 MI Part B Supplier - Clinic/Group Practice 9638252687 Receives reassigned benefits from 6 practitioners
Practice locations: Brownstown TWP, MI; Dearborn, MI

National Provider Directory

National Provider Directory

Locations

19135 Allen Rd
Ste 106
Brownstown Twp, MI 48183
Phone (734) 362-9032

19135 Allen Rd
Brownstown Twp, MI 48183
Phone (734) 486-4700

1951 Monroe St
Dearborn, MI 48124
Phone (313) 563-5757

Practitioners & affiliated clinicians

Practitioners 9

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": "1195084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493164800000",
    "number": "1649451964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1951 MONROE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242916",
            "telephone_number": "313-563-5757",
            "fax_number": "313-563-5760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 MONROE ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242916",
            "telephone_number": "313-563-5757",
            "fax_number": "313-563-5760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-15",
        "last_updated": "2017-04-26",
        "status": "A",
        "authorized_official_last_name": "GHORAYEB",
        "authorized_official_first_name": "GHADI",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-563-5757",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Phlebology",
            "state": "MI",
            "license": "GG078483",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "GG078483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "110H232600",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "110H232600",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.