NPIMap

Individual provider Active NPI

Fares S. Hakim, MD

  • Gastroenterology Physician
  • Southfield, MI
National Provider Identifier
1841383304
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME81200 Issued in FL
Practice address
26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849
Phone
(947) 522-0688
NPI assigned
Oct 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 0101227714 VA
Gastroenterology Physician 207RG0100X ME81200 FL Primary

Addresses

Primary practice location

26901 Beaumont Blvd Ste 3D
Southfield, MI 48033-3849

Mailing address

4828 N Davis Hwy
Pensacola, FL 32503-2341
Phone (850) 477-8109

Other practice location 1

5147 N 9th Ave Ste 311
Pensacola, FL 32504-8770
Phone (850) 477-2597

Other identifiers 9

IdentifierTypeStateIssuer
100014631OtherRAILROAD MEDICARE
A954OtherHEALTH OPTIONS
001996645001OtherUNITED HEALTH CARE
0494478OtherCIGNA
059027297OtherALBCBS OF ALABAMA
009937070MedicaidAL
51643OtherFLBCBS OF FLORIDA
7940192OtherAETNA
259729200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA, VA3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20051206000760 FL Practitioner - Gastroenterology 9830119742 Reassigns benefits to 5 organizations
I20200608000697 GA Practitioner - Gastroenterology 9830119742
I20240201003012 VA Practitioner - Gastroenterology 9830119742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1510 N 28TH St
Richmond, VA 23223-5311

4485 Woodbine Rd
Pace, FL 32571-8726
Phone (850) 477-2597

5801 Bremo Rd
Richmond, VA 23226-1907
Phone (804) 764-6000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy180
Upper gastrointestinal (GI) endoscopy for acid reflux247

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME81200FLMDGastroenterology Physician
0101227714VAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Jan 1, 2024 Accepting new patients
Health First Medical Group, LLC Gastroenterology CurrentSince Dec 19, 2022 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Nov 1, 2023 Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Jan 1, 2024 Accepting new patients
Lee Health System Inc CurrentSince Dec 28, 2024 Accepting new patients
Lee Health System Inc CurrentSince Dec 28, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Oct 18, 2021 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Nov 1, 2023 Accepting new patients
Health First Medical Group, LLC CurrentSince Dec 19, 2022 Accepting new patients
Gastroenterology Associates of Pensacola PA CurrentSince May 26, 2025 Accepting new patients
Lee Memorial Health System CurrentSince Oct 18, 2021 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

699 W Cocoa Beach Cswy
Ste 405
Cocoa Beach, FL 32931
Phone (321) 868-7272

701 W Cocoa Beach Cswy
Cocoa Beach, FL 32931
Phone (321) 799-7111

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

16410 Healthpark Commons Dr
Fort Myers, FL 33908

9800 S Healthpark Dr
Ste 110
Fort Myers, FL 33908
Phone (239) 344-2307

1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

4485 Woodbine Rd
Pace, FL 32571

4828 N Davis Hwy
Pensacola, FL 32503

4531 N Davis Hwy
Fl 2
Pensacola, FL 32503

9400 University Pkwy
Pensacola, FL 32514
Phone (850) 208-6000

4810 N Davis Hwy
Pensacola, FL 32503
Phone (850) 474-8988

5147 N 9th Ave
Ste 311
Pensacola, FL 32504

1510 N 28th St
Ste 110
Richmond, VA 23223
Phone (804) 545-2304

Interoperability endpoints

  • Direct secure messaging: fares.hakim@gastrohealth.eclinicaldirectplus.com
  • Direct secure messaging: fhakim71680@epicdirect.hf.org
  • Direct secure messaging: fhakim2487595@direct.bsmhealth.org

Organizations & group practices 12

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 11

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1841383304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4828 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032341",
            "telephone_number": "850-477-8109",
            "fax_number": "850-478-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD STE 3D",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849",
            "telephone_number": "947-522-0688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5147 N 9th Ave Ste 311",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325048770",
            "country_code": "US",
            "telephone_number": "850-477-2597",
            "fax_number": "850-478-7941",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAKIM",
        "first_name": "FARES",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "VA",
            "license": "0101227714",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME81200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "100014631",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH OPTIONS",
            "identifier": "A954",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "001996645001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0494478",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "059027297",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009937070",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "51643",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7940192",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259729200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.