Individual provider Active NPI

Najam Mohammad Fasiuddin, D.O.

  • Emergency Medicine Physician
  • Trenton, MI
National Provider Identifier
1679725154
Registry record updated Oct 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101017662 Issued in MI
Practice address
5450 Fort St
Medical Education
Trenton, MI 48183-4601
Phone
(734) 671-3297
NPI assigned
Oct 16, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101017662 MI Primary
Emergency Medicine Physician 207P00000X 5315035986 MI

Addresses

Primary practice location

5450 Fort St
Medical Education
Trenton, MI 48183-4601

Mailing address

150 Lincoln LN
Apt 2801
Dearborn, MI 48126-6106
Phone (732) 213-4779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20180328001529 FL Practitioner - Emergency Medicine 6204091002 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5315035986MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa Bay Emergency Physicians LLC Emergency Medicine CurrentSince Mar 14, 2018 Accepting new patients
Tampa Bay Emergency Physicians-Heartland LLC Emergency Medicine CurrentSince Sep 1, 2024 Accepting new patients

Locations

4200 Sun N Lake Blvd
Sebring, FL 33872
Phone (863) 314-4406

3100 E Fletcher Ave
Tampa, FL 33613
Phone (813) 615-7200

7171 N Dale Mabry Hwy
Tampa, FL 33614
Phone (813) 558-8001

1395 S Pinellas Ave
Tarpon Springs, FL 34689
Phone (727) 942-5000

735 S 5th Ave
Wauchula, FL 33873
Phone (863) 402-3402

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224115200000",
    "number": "1679725154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 LINCOLN LN",
            "address_2": "APT 2801",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481266106",
            "telephone_number": "732-213-4779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5450 FORT ST",
            "address_2": "MEDICAL EDUCATION",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481834601",
            "telephone_number": "734-671-3297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASIUDDIN",
        "first_name": "NAJAM",
        "middle_name": "MOHAMMAD",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-16",
        "last_updated": "2008-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101017662",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5315035986",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, MI

Sources for this page

Verify at the official NPI Registry.