Henry Ford Macomb Hospital Corporation

Primary specialty

Rehabilitation HospitalTaxonomy code 283X00000X

Legal business name

HENRY FORD MACOMB HOSPITAL CORPORATION

Practice address

13355 East 10 Mile Rd
Warren, MI 48089-2048

Phone

(313) 874-4633

Fax

(313) 874-3943

NPI assigned

Jun 21, 2006

Organization subpart

Yes

Parent organization

HENRY FORD MACOMB HOSPITAL CORPORATIONAs reported in NPPES

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

Authorized official

Name

Mr. James M Connelly I

Title

Sr Vice President

Phone

(313) 874-8714

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Henry Ford Macomb Hospital- Warren Campus Other name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Hospital certification: CCN 23T047

Legal name

HENRY FORD MACOMB HOSPITAL CORPORATION

Doing business as

HENRY FORD MACOMB HOSPITAL

Organization structure

CorporationNon-profit

Enrollment address

15855 19 Mile Rd
Clinton Township, MI 48038-3504
Hospital Rehabilitation Unit

Hospital subgroups

Rehabilitation unit

Related certifications (CCN) 2

Facilities connected through Provider of Services related, parent or unit certification numbers.

• Henry Ford Macomb Hospital Corporation

  • General Acute Care Hospital
  • Clinton TWP, MI
  • NPI 1023114634

  Unit of hospital

  Provider of Services
• Henry Ford Macomb Hospital Corporation

  • General Acute Care Hospital
  • Warren, MI
  • NPI 1902842735

  Unit of hospital

  Provider of Services

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Henry Ford Macomb Hospital Corporation

  • Rehabilitation Hospital Unit
  • Clinton TWP, MI
  • NPI 1942399829

  O20070711001021

  Same enrollment

Listed as

Henry Ford Macomb HospitalCCN 23T047

Ownership

Non-profit

Certified

Jul 1, 1990

Part of

Macomb Cy Com Men H

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Henry Ford Health System

  • Optometrist
  • Detroit, MI
  • NPI 1346324688

  Member Of

  NPD member

All disclosed owners & managing parties 31

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Farzan Siddiqui, M.D., PH.D.

  • Radiation Oncology Physician
  • Detroit, MI
  • NPI 1922217793

  Corporate Director

  CMS ownership
• Lisa Fitzpatrick, MD, MPH

  • Internal Medicine Physician
  • Washington, DC
  • NPI 1588664056

  Corporate Director

  CMS ownership

Affiliated clinicians 8

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Sami Elias Asmar, M.D.

  • Internal Medicine Physician
  • Sterling Heights, MI
  • NPI 1861466500

  Inpatient rehabilitation facility

  Care Compare affiliation
• Cody Andrew Brush, DPM

  • Foot & Ankle Surgery Podiatrist
  • Clinton Township, MI
  • NPI 1801259551

  Inpatient rehabilitation facility

  Care Compare affiliation
• David K Davis, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Clinton Township, MI
  • NPI 1285638080

  Inpatient rehabilitation facility

  Care Compare affiliation
• Bhadresh Dhirubhai Nayak, MD

  • Hematology & Oncology Physician
  • Sterling Heights, MI
  • NPI 1295708980

  Inpatient rehabilitation facility

  Care Compare affiliation
• Aaron Peter Salem, MD

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1487149787

  Inpatient rehabilitation facility

  Care Compare affiliation
• Gail Diane Soohoo-Williams, MD

  • Physical Medicine & Rehabilitation Physician
  • Clinton Township, MI
  • NPI 1578558318

  Inpatient rehabilitation facility

  Care Compare affiliation
• Douglas Stanley Verrill, MD

  • Physical Medicine & Rehabilitation Physician
  • Ann Arbor, MI
  • NPI 1073926861

  Inpatient rehabilitation facility

  Care Compare affiliation
• Ahmed Zaki

  • Internal Medicine Physician
  • Rochester, MI
  • NPI 1548750730

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294790400000",
    "number": "1811933641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13355 EAST 10 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480892048",
            "telephone_number": "313-874-4633",
            "fax_number": "313-874-3943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13355 EAST 10 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480892048",
            "telephone_number": "313-874-4633",
            "fax_number": "313-874-3943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY FORD MACOMB HOSPITAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HENRY FORD MACOMB HOSPITAL CORPORATION",
        "enumeration_date": "2006-06-21",
        "last_updated": "2011-01-12",
        "status": "A",
        "authorized_official_last_name": "CONNELLY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SR VICE PRESIDENT",
        "authorized_official_telephone_number": "313-874-8714",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "I"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942399829",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Henry Ford Macomb Hospital- Warren Campus",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Henry Ford Health Macomb-Oakland Hospital
• Henry Ford Health Macomb-Oakland Hospital
• Henry Ford Health System
• Henry Ford Hospital Macomb Warren Campus
• Henry Ford Macomb Hospital Corporation
• Henry Ford Macomb Hospital Corporation
• Henry Ford Macomb Hospital Warren Campus
• Henry Ford Macomb Hospital Warren Campus Lobby Phcy
• Henry Ford Macomb-Warren Hospital
• Henry Ford Semi Medical Group

• Rehabilitation Hospital in Warren, MI
• Providers in Warren, MI by specialty
• Rehabilitation Hospital in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.