NPIMap

Individual provider Active NPI

Rafic Beydoun, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Detroit, MI
National Provider Identifier
1831455138
Registry record updated Feb 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
4301087036 Issued in MI
Practice address
3990 John R St
Detroit, MI 48201-2018
Phone
(313) 745-8555
Fax
(313) 745-9299
NPI assigned
Apr 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 4301087036 MI Primary

Addresses

Primary practice location

3990 John R St
Detroit, MI 48201-2018

Mailing address

1560 E. Maple Rd
Suite 400-Credentialing
Troy, MI 48083-1135
Phone (248) 581-5974

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120808000945 MI Practitioner - Pathology 9638325541 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samir Al-Hadidi MD PCGroup PAC ID 3476627050, 4 clinicians
North Oakland Gastroenterology Clinic PCGroup PAC ID 7315991577, 4 clinicians
University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

1349 S Rochester Rd
Suite 210
Rochester Hills, MI 48307-3152
Phone (248) 844-2600

3990 John R St
Detroit, MI 48201-2018
Phone (313) 745-8040

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301087036MIMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Group Anatomic Pathology & Clinical Pathology CurrentSince Aug 1, 2012 Accepting new patients
KC Pathology Laboratory LLC Current Accepting new patients
North Oakland Gastroenterology Clinic PC CurrentSince Sep 1, 2012 Accepting new patients
Warren Gastroenterology PC CurrentSince May 4, 2024 Accepting new patients
University Physician Group Past Accepting new patients

Locations

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

3990 John R St
Detroit, MI 48201
Phone (313) 745-6211

2700 S Rochester Rd
Rochester Hills, MI 48307
Phone (248) 212-0777

1349 S Rochester Rd
Ste 210
Rochester Hills, MI 48307
Phone (248) 844-2600

1560 E Maple Rd
Ste 400
Troy, MI 48083

1560 E Maple Rd
Ste 200
Troy, MI 48083
Phone (248) 581-5200

27560 Hoover Rd
Warren, MI 48093
Phone (586) 573-5890

Interoperability endpoints

  • Direct secure messaging: rbeydoun@direct.dmc.org

Organizations & group practices 6

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.

Hospital & facility affiliations 4

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": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424995200000",
    "number": "1831455138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 E. MAPLE RD",
            "address_2": "SUITE 400-CREDENTIALING",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831135",
            "telephone_number": "248-581-5974",
            "fax_number": "248-581-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012018",
            "telephone_number": "313-745-8555",
            "fax_number": "313-745-9299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEYDOUN",
        "first_name": "RAFIC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-11",
        "last_updated": "2015-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "4301087036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.