Organization Active NPI

Kareem H Bazzi MD PLLC

  • Family Medicine Physician
  • Detroit, MI
National Provider Identifier
1861171407
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
KAREEM H BAZZI MD PLLC
Practice address
17751 E Warren Ave
Detroit, MI 48224-1329
Phone
(313) 885-6833
Fax
(737) 207-9070
NPI assigned
Jul 12, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Authorized official

Name
Samantha Middleton
Title
Credentialing
Phone
(989) 321-8918

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

17751 E Warren Ave
Detroit, MI 48224-1329

Mailing address

PO Box 3272
Saginaw, MI 48605-3272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231006000349 MI Part B Supplier - Clinic/Group Practice 0042665366 Receives reassigned benefits from 1 practitioner
Practice locations: Detroit, MI; Southgate, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1689120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689120000000",
    "number": "1861171407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3272",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486053272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17751 E WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482241329",
            "telephone_number": "313-885-6833",
            "fax_number": "737-207-9070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAREEM H BAZZI MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-12",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A",
        "authorized_official_last_name": "MIDDLETON",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "989-321-8918"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.