Individual provider Active NPI

Fady Yasso

  • Internal Medicine Physician
  • Farmington Hills, MI
National Provider Identifier
1851719991
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301105867 Issued in MI
Practice address
30055 Northwestern Hwy Ste 170
Farmington Hills, MI 48334-3231
Phone
(248) 539-0729
Fax
(248) 539-0740
NPI assigned
Apr 5, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301105867 MI Primary

Addresses

Primary practice location

30055 Northwestern Hwy Ste 170
Farmington Hills, MI 48334-3231

Mailing address

30055 Northwestern Hwy Ste 170
Farmington Hills, MI 48334-3231
Phone (248) 539-0729

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170719001233 MI Practitioner - Internal Medicine 0345541249 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

4201 Saint Antoine St
Detroit, MI 48201-2153
Phone (313) 745-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301105867MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
VHS Physicians of Michigan Internal Medicine CurrentSince Jun 7, 2018 Accepting new patients
University Physician Group Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients
Birmingham Maple Clinic Past Accepting new patients
VHS Harper-Hutzel Hospital Inc Past Accepting new patients

Locations

4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615

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

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

47601 Grand River Ave
Novi, MI 48374
Phone (248) 465-4100

16001 W 9 Mile Rd
Southfield, MI 48075
Phone (248) 424-3000

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

Interoperability endpoints

  • Direct secure messaging: fyasso@direct.dmc.org
  • Direct secure messaging: fady.yasso.1@19711.direct.athenahealth.com
  • Direct secure messaging: fyasso1158376@direct.hfhs.org

Organizations & group practices 4

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 2

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": "1396656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1851719991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30055 NORTHWESTERN HWY STE 170",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343231",
            "telephone_number": "248-539-0729",
            "fax_number": "248-539-0740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30055 NORTHWESTERN HWY STE 170",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343231",
            "telephone_number": "248-539-0729",
            "fax_number": "248-539-0740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YASSO",
        "first_name": "FADY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301105867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

Verify at the official NPI Registry.