Individual provider Active NPI

Mohamed Farrag, PHD

  • Psychologist
  • Dearborn, MI
National Provider Identifier
1770695157
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
23400 Michigan Ave
Suite 405
Dearborn, MI 48124-1924
Phone
(313) 730-8118
NPI assigned
Aug 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X MI Primary

Addresses

Primary practice location

23400 Michigan Ave
Suite 405
Dearborn, MI 48124-1924

Mailing address

1110 Eldon Baker Dr
Flint, MI 48507-1923
Phone (810) 744-3600

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080228000034 MI Practitioner - Clinical Psychologist 4284718370 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75.05 of 100Reported as group
Quality
0
Promoting interoperability
100
Improvement activities
40
Cost
83.49

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
BCS of Michigan LLC Psychologist CurrentSince Jun 2, 2015 Accepting new patients

Locations

39465 W 14 Mile Rd
Novi, MI 48377
Phone 24885939000

5500 Fort St
Trenton, MI 48183
Phone (734) 287-3000

28800 Ryan Rd
Ste 320
Warren, MI 48092
Phone (586) 582-0500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770695157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 ELDON BAKER DR",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485071923",
            "telephone_number": "810-744-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23400 MICHIGAN AVE",
            "address_2": "SUITE 405",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241924",
            "telephone_number": "313-730-8118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRAG",
        "first_name": "MOHAMED",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.