Individual provider Active NPI

Raida Alazem, MD

  • Internal Medicine Physician
  • Dearborn, MI
National Provider Identifier
1710919337
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
RA072037 Issued in MI
Practice address
4700 Greenfield Rd
Dearborn, MI 48126-4124
Phone
(313) 945-6100
Fax
(313) 945-5260
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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 RA072037 MI Primary

Addresses

Primary practice location

4700 Greenfield Rd
Dearborn, MI 48126-4124

Mailing address

4700 Greenfield Rd
Dearborn, MI 48126-4124
Phone (313) 945-6100

Other identifiers 1

IdentifierTypeStateIssuer
4774593MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20050207000325 MI Practitioner - Internal MedicinePractitioner - Family Practice 6002867108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Family Practice
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Physicians of Dearborn PLLCGroup PAC ID 5698667194, 4 clinicians

Practice addresses (Care Compare)

4700 Greenfield Rd
Dearborn, MI 48126-4124
Phone (313) 945-6100

Hospital & facility affiliations

  • Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RA072037MIMDInternal Medicine Physician

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1710919337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 GREENFIELD RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481264124",
            "telephone_number": "313-945-6100",
            "fax_number": "313-945-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 GREENFIELD RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481264124",
            "telephone_number": "313-945-6100",
            "fax_number": "313-945-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALAZEM",
        "first_name": "RAIDA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "RA072037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4774593",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.