Organization Active NPI

Salzac Medical Group PC

  • Family Medicine Physician
  • Southfield, MI
National Provider Identifier
1679421283
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SALZAC MEDICAL GROUP PC
Practice address
21701 W 11 Mile Rd Ste 5
Southfield, MI 48076-3713
Phone
(248) 569-7550
Fax
(248) 569-7552
NPI assigned
Mar 19, 2026
Last updated
Mar 19, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2026

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

Authorized official

Name
Zakari Tata, MDNPI 1871591313
Title
Director
Phone
(248) 787-8197

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

21701 W 11 Mile Rd Ste 5
Southfield, MI 48076-3713

Mailing address

21701 W 11 Mile Rd Ste 5
Southfield, MI 48076-3713
Phone (248) 569-7550

Other practice location 1

20129 Connor St
Detroit, MI 48234
Phone (248) 569-7550

Other practice location 2

20000 Dequindre St
Detroit, MI 48234-4512
Phone (248) 569-7550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260420001968 MI Part B Supplier - Clinic/Group Practice 7416423157 Receives reassigned benefits from 2 practitioners
Practice locations: Detroit, MI; Southfield, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1773878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773878400000",
    "number": "1679421283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21701 W 11 MILE RD STE 5",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480763713",
            "telephone_number": "248-569-7550",
            "fax_number": "248-569-7552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21701 W 11 MILE RD STE 5",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480763713",
            "telephone_number": "248-569-7550",
            "fax_number": "248-569-7552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20129 Connor St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "48234",
            "country_code": "US",
            "telephone_number": "248-569-7550",
            "fax_number": "248-569-7552",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20000 Dequindre St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482344512",
            "country_code": "US",
            "telephone_number": "248-569-7550",
            "fax_number": "248-569-7552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SALZAC MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-19",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-13",
        "status": "A",
        "authorized_official_last_name": "TATA",
        "authorized_official_first_name": "ZAKARI",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "248-787-8197",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2026; 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.