Individual provider Active NPI

Itemad Badr, MD

  • Pediatrics Physician
  • Detroit, MI
National Provider Identifier
1659318657
Registry record updated Mar 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301069441 Issued in MI
Practice address
Childrens Hospital Mi Immunology/Allergy/Rheum
3901 Beaubien 5TH FLR Carl&Apos;S Building
Detroit, MI 48201
Phone
(313) 745-4450
NPI assigned
May 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301069441 MI Primary

Addresses

Primary practice location

Childrens Hospital Mi Immunology/Allergy/Rheum
3901 Beaubien 5TH FLR Carl&Apos;S Building
Detroit, MI 48201

Mailing address

3800 Woodward Ave
Suite 702
Detroit, MI 48201-2061

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20031212000354 MI Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 0648176206 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Pediatric Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Suresh Anne MD PCGroup PAC ID 5395801708, 4 clinicians

Practice addresses (Care Compare)

23601 Ford Rd
Suite 1
Dearborn, MI 48128-1227
Phone (313) 724-1124

4792 Rochester Rd
Troy, MI 48085-4989
Phone (248) 528-9010

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Asthma & Allergy Family Clinic PC Allergy & Immunology CurrentSince Dec 1, 2004 Accepting new patients
Allergy & Asthma Management Center PC Allergy & Immunology Past Accepting new patients

Locations

23601 Ford Rd
Ste 1
Dearborn, MI 48128
Phone (313) 724-1124

23601 Ford Rd
Dearborn, MI 48128
Phone (313) 561-6910

1083 Suncrest Dr
Ste B
Lapeer, MI 48446
Phone (810) 245-5390

Organizations & group practices 3

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 2

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395878400000",
    "number": "1659318657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 WOODWARD AVE",
            "address_2": "SUITE 702",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CHILDRENS HOSPITAL MI IMMUNOLOGY/ALLERGY/RHEUM",
            "address_2": "3901 BEAUBIEN 5TH FLR CARL'S BUILDING",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201",
            "telephone_number": "313-745-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADR",
        "first_name": "ITEMAD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2014-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301069441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.