Individual provider Active NPI

Reza Dabir, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Dearborn, MI
National Provider Identifier
1750351383
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
4301055037 Issued in MI
Practice address
22060 Beech St Ste 300
Dearborn, MI 48124-2847
Phone
(313) 228-0230
Fax
(313) 228-0231
NPI assigned
Jan 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 4301055037 MI Primary

Addresses

Primary practice location

22060 Beech St Ste 300
Dearborn, MI 48124-2847

Mailing address

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone (947) 522-1863

Other identifiers 1

IdentifierTypeStateIssuer
4606140MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rdabir120175@direct.beaumont.edu

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
I20040602000415 MI Practitioner - Thoracic SurgeryPractitioner - Cardiac Surgery 3375525629 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Thoracic Surgery
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health Providence HospitalGroup PAC ID 6103738703, 364 clinicians

Practice addresses (Care Compare)

1 Genesys Pkwy
Suite 3452
Grand Blanc, MI 48439-8065
Phone (248) 849-2600

1400 Genesys Pkwy
B136
Grand Blanc, MI 48439-8068
Phone (810) 606-7629

Hospital & facility affiliations

  • Ascension Genesys Hospital Hospital, Grand Blanc, MI, CCN 230197

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary artery bypass graft (CABG)27

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health Providence Hospital CurrentSince Dec 1, 2021 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital CurrentSince Dec 1, 2021 Accepting new patients
Henry Ford Health Providence Hospital CurrentSince Dec 1, 2021 Accepting new patients
Henry Ford Health Macomb-Oakland Hospital Thoracic Surgery (Cardiothoracic Vascular Surgery) CurrentSince Dec 1, 2021 Accepting new patients
Henry Ford Health Genesys Hospital Past Accepting new patients

Locations

1 Genesys Pkwy
Ste 3452
Grand Blanc, MI 48439
Phone (248) 849-2600

1400 Genesys Pkwy
#B136
Grand Blanc, MI 48439
Phone (810) 606-7629

27483 Dequindre Rd
Ste 204
Madison Hts, MI 48071
Phone (248) 967-7326

26850 Providence Pkwy
Ste 470
Novi, MI 48374
Phone (248) 319-3000

1135 W University Dr
Ste 230
Rochester Hls, MI 48307
Phone (248) 824-2630

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

16001 W 9 Mile Rd
#3
Southfield, MI 48075
Phone (248) 384-9260

11900 E 12 Mile Rd
Ste 308
Warren, MI 48093
Phone (586) 574-5080

Organizations & group practices 5

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 1

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": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1750351383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-1863",
            "fax_number": "047-522-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22060 BEECH ST STE 300",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481242847",
            "telephone_number": "313-228-0230",
            "fax_number": "313-228-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DABIR",
        "first_name": "REZA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MI",
            "license": "4301055037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4606140",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rdabir120175@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "22060 Beech St Ste 300",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481242847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.