NPIMap

Individual provider Active NPI

Farzin Reza Namei, MD

  • Family Medicine Physician
  • Saint Clair Shores, MI
National Provider Identifier
1700883345
Registry record updated Oct 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301053449 Issued in MI
Practice address
24100 Little Mack Ave
Saint Clair Shores, MI 48080-3247
Phone
(586) 443-4063
Fax
(586) 443-4064
NPI assigned
Jun 28, 2005
Last updated
Oct 30, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2008

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 4301053449 MI Primary

Addresses

Primary practice location

24100 Little Mack Ave
Saint Clair Shores, MI 48080-3247

Mailing address

24100 Little Mack Ave
Saint Clair Shores, MI 48080-3247
Phone (586) 443-4063

Other identifiers 1

IdentifierTypeStateIssuer
700E012740OtherMIBCBSM GROUP NUMBER

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
I20050727001100 MI Practitioner - Family Practice 7618864893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

24100 Little Mack Ave
Saint Clair Shores, MI 48080-3247
Phone (586) 443-4063

46591 Romeo Plank Rd
Suite 137
Macomb, MI 48044-5743
Phone (586) 226-6269

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital CurrentSince Oct 1, 2010 Accepting new 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
Heritage Medical Group Past Accepting new patients
Ascension Medical Group Michigan Past Accepting new patients
Henry Ford Health St. John Hospital Family Medicine Past Accepting new patients

Locations

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

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

24100 Little Mack Ave
Saint Clair Shores, MI 48080
Phone (586) 443-4063

45634 Schoenherr Rd
Utica, MI 48315
Phone (586) 532-8440

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 7

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": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225324800000",
    "number": "1700883345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24100 LITTLE MACK AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480803247",
            "telephone_number": "586-443-4063",
            "fax_number": "586-443-4064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24100 LITTLE MACK AVE",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480803247",
            "telephone_number": "586-443-4063",
            "fax_number": "586-443-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAMEI",
        "first_name": "FARZIN",
        "middle_name": "REZA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2008-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301053449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM GROUP NUMBER",
            "identifier": "700E012740",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

Verify at the official NPI Registry.