Individual provider Active NPI

Hawirah Faraj, FNP-BC

  • Primary Care Nurse Practitioner
  • Dearborn, MI
National Provider Identifier
1790552073
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
4704346161 Issued in MI
Practice address
4900 Mercury Dr
Dearborn, MI 48126-2947
Phone
(313) 816-1600
NPI assigned
Dec 7, 2023
Last updated
Dec 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 4704346161 MI Primary

Addresses

Primary practice location

4900 Mercury Dr
Dearborn, MI 48126-2947

Mailing address

1573 Sherwood CT
Dearborn, MI 48124-4015
Phone (313) 445-0115

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250312000157 MI Practitioner - Nurse Practitioner 4183145758 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704346161MIMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Barbara Ann Karmanos Cancer Institute CurrentSince Jan 2, 2025 Accepting new patients
Barbara Ann Karmanos Cancer Institute CurrentSince Jan 2, 2025 Accepting new patients
Barbara Ann Karmanos Cancer Institute Past Accepting new patients

Locations

18800 Hubbard Dr
Dearborn, MI 48126
Phone (313) 576-9182

4100 John R St
Detroit, MI 48201
Phone (313) 576-8530

31995 Northwestern Hwy
Farmington Hills, MI 48334
Phone (248) 538-4701

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, 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": "1701907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1790552073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1573 SHERWOOD CT",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244015",
            "telephone_number": "313-445-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 MERCURY DR",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262947",
            "telephone_number": "313-816-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARAJ",
        "first_name": "HAWIRAH",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-07",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704346161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.