NPIMap

Individual provider Active NPI

Wafa Elhassan, MD

  • Internal Medicine Physician
  • Dearborn, MI
National Provider Identifier
1699115535
Registry record updated Jan 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301103593 Issued in MI
Practice address
18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone
(313) 593-7000
NPI assigned
Jun 25, 2013
Last updated
Jan 18, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301103593 MI Primary

Addresses

Primary practice location

18101 Oakwood Blvd
Dearborn, MI 48124-4089

Mailing address

2040 Monroe St
Ste 207
Dearborn, MI 48124-2950
Phone (313) 278-5836

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
I20180124000733 MI Practitioner - Internal Medicine 8022377878 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baco Care Services LLCGroup PAC ID 6103286737, 13 clinicians
Wafa a Elhassan MD PLLCGroup PAC ID 5799119301, 2 clinicians

Practice addresses (Care Compare)

26911 Northwestern Hwy
Suite 530
Southfield, MI 48033-4717
Phone (313) 530-5494

4020 Venoy Rd
Suite 300
Wayne, MI 48184-1899
Phone (734) 589-1090

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wafa a Elhassan MD PLLC CurrentSince Nov 1, 2019 Accepting new patients
Baco Care Services LLC Internal Medicine CurrentSince May 1, 2025 Accepting new patients
Normita Vicencio MD PC Internal Medicine CurrentSince Nov 20, 2019 Accepting new patients
Oakwood Healthcare, Inc. Past Accepting new patients
Oakwood Health Promotions, Inc. Past Accepting new patients
Oakwood Healthcare, Inc. Past Accepting new patients

Locations

1905 S Haggerty Rd
Canton, MI 48188
Phone (734) 589-1090

26911 Northwestern Hwy
Ste 530
Southfield, MI 48033
Phone (313) 530-5494

4020 Venoy Rd
Ste 300
Wayne, MI 48184
Phone (734) 589-1090

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516233600000",
    "number": "1699115535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 MONROE ST",
            "address_2": "STE 207",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242950",
            "telephone_number": "313-278-5836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244089",
            "telephone_number": "313-593-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELHASSAN",
        "first_name": "WAFA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2018-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301103593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.