Individual provider Active NPI

Ezzat Ali Farhat, MD

  • Family Medicine Physician
  • Detroit, MI
National Provider Identifier
1780305268
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301514596 Issued in MI
Practice address
3031 W Grand Blvd Ste 600
Detroit, MI 48202-3014
Phone
(313) 871-3751
NPI assigned
Sep 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301514596 MI Primary

Addresses

Primary practice location

3031 W Grand Blvd Ste 600
Detroit, MI 48202-3014

Mailing address

5714 Middlesex St
Dearborn, MI 48126-5022
Phone (313) 704-8610

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
I20250725000320 MI Practitioner - Family Practice 4486161486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10912 Wayne Rd
Romulus, MI 48174-1471
Phone (734) 955-7000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301514596MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of Michigan PC CurrentSince Jul 21, 2025 Accepting new patients
American Current Care of Michigan PC Current Accepting new patients
Woodward Detroit CVS, L.L.C. PastSince Sep 1, 2022 Accepting new patients

Locations

436 44th St SE
Ste A
Kentwood, MI 49548
Phone (616) 531-9750

10912 Wayne Rd
Romulus, MI 48174
Phone (734) 955-7000

11569 E 12 Mile Rd
Warren, MI 48093
Phone (586) 582-0018

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1662336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1780305268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5714 MIDDLESEX ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481265022",
            "telephone_number": "313-704-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 W GRAND BLVD STE 600",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023014",
            "telephone_number": "313-871-3751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARHAT",
        "first_name": "EZZAT",
        "middle_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-05",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301514596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.