Organization Active NPI

Samir Al-Hadidi MD PC

  • Gastroenterology Physician
  • Rochester Hills, MI
National Provider Identifier
1720249782
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
SA045286 Issued in MI
Legal business name
SAMIR AL-HADIDI MD PC
Practice address
1349 S Rochester Rd
Suite 210
Rochester Hills, MI 48307-5821
Phone
(248) 844-0991
Fax
(248) 844-0991
NPI assigned
Jun 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Authorized official

Name
Samir S Al-Hadidi, MDNPI 1407960453
Title
Medical Doctor
Phone
(248) 844-2600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X SA045286 MI Primary

Addresses

Primary practice location

1349 S Rochester Rd
Suite 210
Rochester Hills, MI 48307-5821

Mailing address

PO Box 71066
Rochester, MI 48307-5821
Phone (248) 844-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080730000551 MI Part B Supplier - Clinic/Group Practice 3476627050 Receives reassigned benefits from 4 practitioners
Practice locations: Rochester Hills, MI

National Provider Directory

National Provider Directory
Tax ID family
Barclay Histopathology Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1349 S Rochester Rd
Ste 200
Rochester Hills, MI 48307

27560 Hoover Rd
Warren, MI 48093
Phone (586) 573-5890

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576022400000",
    "number": "1720249782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71066",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483075821",
            "telephone_number": "248-844-2600",
            "fax_number": "248-844-0991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1349 S ROCHESTER RD",
            "address_2": "SUITE 210",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483075821",
            "telephone_number": "248-844-0991",
            "fax_number": "248-844-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMIR AL-HADIDI MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-23",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A",
        "authorized_official_last_name": "AL-HADIDI",
        "authorized_official_first_name": "SAMIR",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "248-844-2600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MI",
            "license": "SA045286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.