Active NPI
Mohammad Ghaziuddin, MD
- Child & Adolescent Psychiatry Physician
- Ann Arbor, MI
National Provider Identifier
1710059233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- 4301053310
- Practice address
- 4250 Plymouth Rd
Ann Arbor, MI 48109-2700 - Phone
- (734) 764-6443
- NPI assigned
- Nov 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Child & Adolescent Psychiatry Physician | 2084P0804X | 4301053310 | MI | Primary |
| Psychiatry Physician | 2084P0800X | 4301053310 | MI |
Addresses
Primary practice location
4250 Plymouth Rd
Ann Arbor, MI 48109-2700
Mailing address
3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2694009 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- mghaziuddin48307@direct.med.umich.edu
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580169600000",
"number": "1710059233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3621 S STATE ST",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481081633",
"telephone_number": "734-647-5299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4250 PLYMOUTH RD",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481092700",
"telephone_number": "734-764-6443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHAZIUDDIN",
"first_name": "MOHAMMAD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-14",
"last_updated": "2020-01-28",
"certification_date": "2020-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "MI",
"license": "4301053310",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "4301053310",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2694009",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.