Individual provider Active NPI

Farah Bazzi, NP

  • Nurse Practitioner
  • Dearborn, MI
National Provider Identifier
1821686213
Registry record updated Jan 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704322517 Issued in MI
Practice address
4700 Greenfield Rd Ste 2E
Dearborn, MI 48126-4124
Phone
(313) 740-1111
Fax
(313) 672-6241
NPI assigned
Jan 2, 2021
Last updated
Jan 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704322517 MI Primary

Addresses

Primary practice location

4700 Greenfield Rd Ste 2E
Dearborn, MI 48126-4124

Mailing address

21157 Fairview Dr
Dearborn Heights, MI 48127-2686
Phone (313) 310-5710

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL Dearborn
Direct Messaging Address dearbornoffice@bazzimd.com

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
I20210126001989 MI Practitioner - Nurse Practitioner 3971917360 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providers Tek IncGroup PAC ID 2264792084, 13 clinicians

Practice addresses (Care Compare)

4700 Greenfield Rd
Suite 2E
Dearborn, MI 48126-4124
Phone (313) 740-1111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
87.2
Promoting interoperability
100
Improvement activities
40
Cost
86.21

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Riverview Neuromuscular Pain Center PLLC CurrentSince Sep 1, 2021 Accepting new patients
Providers Tek Inc. CurrentSince Jan 4, 2021 Accepting new patients
M&L Quality of Life PLC CurrentSince Jan 4, 2021 Accepting new patients

Locations

4700 Greenfield Rd
Ste 2E
Dearborn, MI 48126
Phone (313) 740-1111

7633 E Jefferson Ave
Ste 170
Detroit, MI 48214
Phone (313) 401-0256

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.

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": "1609545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609545600000",
    "number": "1821686213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21157 FAIRVIEW DR",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481272686",
            "telephone_number": "313-310-5710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 GREENFIELD RD STE 2E",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481264124",
            "telephone_number": "313-740-1111",
            "fax_number": "313-672-6241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAZZI",
        "first_name": "FARAH",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-02",
        "last_updated": "2021-01-02",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704322517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Dearborn",
            "affiliation": "N",
            "address_1": "4700 Greenfield Rd Ste 2E",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481264124",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dearbornoffice@bazzimd.com",
            "affiliation": "N",
            "address_1": "4700 Greenfield Rd Ste 2E",
            "city": "Dearborn",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481264124",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.