NPIMap

Individual provider Active NPI

Fouad A Dakhlallah, MD

  • Internal Medicine Physician
  • Dearborn, MI
National Provider Identifier
1679592877
Registry record updated Dec 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
FD085126 Issued in MI
Practice address
5728 Schaefer Rd
Suite 103
Dearborn, MI 48126-2298
Phone
(313) 581-8080
Fax
(313) 581-8383
NPI assigned
Jul 19, 2006
Last updated
Dec 22, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301085126 MI
Internal Medicine Physician 207R00000X FD085126 MI Primary

Addresses

Primary practice location

5728 Schaefer Rd
Suite 103
Dearborn, MI 48126-2298

Mailing address

5728 Schaefer Rd
Suite 103
Dearborn, MI 48126-2298
Phone (313) 581-8080

Other identifiers 1

IdentifierTypeStateIssuer
4753252MedicaidMI

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
I20050809000963 MI Practitioner - Internal Medicine 9830128958 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prime Care Medical Clinic PLLCGroup PAC ID 1052590171, 5 clinicians

Practice addresses (Care Compare)

5245 Schaefer Rd
Dearborn, MI 48126-3257

5728 Schaefer Rd
Suite 103
Dearborn, MI 48126-2287
Phone (313) 581-8080

6221 University Dr
Dearborn Heights, MI 48127-2587
Phone (347) 623-0746

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301085126MIMDInternal Medicine Physician
FD085126MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fouad a. Dakhlallah,M.D.,P.C. Internal Medicine CurrentSince Feb 25, 2012 Accepting new patients
Prime Care Medical Clinic PLLC Internal Medicine CurrentSince Nov 18, 2010 Accepting new patients
University Physician Group Internal Medicine Past Accepting new patients
Oakwood Healthcare, Inc. Past Accepting new patients
Oakwood Healthcare, Inc. Past Accepting new patients

Locations

5728 Schaefer Rd
Ste 103
Dearborn, MI 48126
Phone (313) 581-8080

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BAIAAA

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Riverview Hospice Care IncWyandotte, MI, CCN 231733 Hospice Contracted Managing Employee May 28, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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.

Hospital & facility affiliations 12

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419206400000",
    "number": "1679592877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5728 SCHAEFER RD",
            "address_2": "SUITE 103",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262298",
            "telephone_number": "313-581-8080",
            "fax_number": "313-581-8383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5728 SCHAEFER RD",
            "address_2": "SUITE 103",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262298",
            "telephone_number": "313-581-8080",
            "fax_number": "313-581-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAKHLALLAH",
        "first_name": "FOUAD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2014-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301085126",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "FD085126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4753252",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.