NPIMap

Individual provider Active NPI

Wasim A Rathur, M.D.

  • Family Medicine Physician
  • Clinton TWP, MI
National Provider Identifier
1679553838
Registry record updated Mar 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301063892 Issued in MI
Practice address
42645 Garfield Rd
Suite 103
Clinton TWP, MI 48038-5022
Phone
(586) 286-0050
Fax
(586) 286-0880
NPI assigned
Jan 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301063892 MI Primary

Addresses

Primary practice location

42645 Garfield Rd
Suite 103
Clinton TWP, MI 48038-5022

Mailing address

43900 Garfield Rd Ste 222
Clinton TWP, MI 48038-1137
Phone (586) 286-0050

Other identifiers 1

IdentifierTypeStateIssuer
1679553838MedicaidMI

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
I20071017000324 MI Practitioner - Family Practice 9234225657 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Semi Medical GroupGroup PAC ID 0648180406, shared by 4 NPIs, 246 clinicians
Henry Ford Cornerstone Medical GroupGroup PAC ID 7517162761, 65 clinicians

Practice addresses (Care Compare)

17900 23 Mile Rd
Macomb, MI 48044-1161
Phone (313) 647-3900

43900 Garfield Rd
Suite 222
Clinton Township, MI 48038-1137
Phone (586) 286-0050

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions19
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital Current Accepting new patients
Henry Ford Health St. John Hospital Family Medicine CurrentSince Oct 1, 2010 Accepting new patients
Henry Ford Health St. John Hospital CurrentSince Oct 1, 2010 Accepting new patients
Rizwan Qadir MD PC Past Accepting new patients
Complete Rehab LLC Past Accepting new patients

Locations

43900 Garfield Rd
Ste 222
Clinton Twp, MI 48038
Phone (586) 263-1234

42645 Garfield Rd
Ste 103
Clinton Twp, MI 48038
Phone (586) 286-0050

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

46591 Romeo Plank Rd
Macomb, MI 48044
Phone (586) 226-6269

15055 22 Mile Rd
Ste 3
Shelby Township, MI 48315
Phone (586) 566-7100

Interoperability endpoints

  • Direct secure messaging: wasim.rathur.2@8209.direct.athenahealth.com
  • Direct secure messaging: wasim.rathur.1@16555.direct.athenahealth.com
  • Direct secure messaging: wrathur241761@direct.hfhs.org

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 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": "1137801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522022400000",
    "number": "1679553838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43900 GARFIELD RD STE 222",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480381137",
            "telephone_number": "586-286-0050",
            "fax_number": "586-286-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42645 GARFIELD RD",
            "address_2": "SUITE 103",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480385022",
            "telephone_number": "586-286-0050",
            "fax_number": "586-286-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATHUR",
        "first_name": "WASIM",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-21",
        "last_updated": "2018-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301063892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679553838",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

Verify at the official NPI Registry.