Organization Active NPI

Michigan Surgical Associates PLLC

  • Surgery Physician
  • Wayne, MI
National Provider Identifier
1861832578
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
5101017213 Issued in MI
Legal business name
MICHIGAN SURGICAL ASSOCIATES PLLC
Practice address
3106 S Wayne Rd
Wayne, MI 48184-1221
Phone
(734) 722-6300
Fax
(734) 722-4815
NPI assigned
Jun 26, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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

Authorized official

Name
Dr. Chadi H Faraj, D.ONPI 1528261088
Title
President
Phone
(313) 673-5997

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 5101017213 MI Primary

Addresses

Primary practice location

3106 S Wayne Rd
Wayne, MI 48184-1221

Mailing address

7350 Horger St
Dearborn, MI 48126-1424
Phone (313) 673-5997

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130725000505 MI Part B Supplier - Clinic/Group Practice 5799926275 Receives reassigned benefits from 2 practitioners
Practice locations: Wayne, MI; Wyandotte, MI; Trenton, MI; Taylor, MI; Allen Park, MI; Dearborn, MI

National Provider Directory

National Provider Directory

Locations

7910 Allen Rd
Ste 101
Allen Park, MI 48101
Phone (313) 436-4746

8338 Allen Rd
Ste 201
Allen Park, MI 48101
Phone (248) 852-1900

15750 Northline Rd
#H
Southgate, MI 48195
Phone (734) 722-6300

3106 S Wayne Rd
#H
Wayne, MI 48184
Phone (734) 722-6300

Practitioners & affiliated clinicians

Practitioners 3

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": "1372204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372204800000",
    "number": "1861832578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7350 HORGER ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261424",
            "telephone_number": "313-673-5997",
            "fax_number": "734-722-4815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3106 S WAYNE RD",
            "city": "WAYNE",
            "state": "MI",
            "postal_code": "481841221",
            "telephone_number": "734-722-6300",
            "fax_number": "734-722-4815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN SURGICAL ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-26",
        "last_updated": "2013-06-26",
        "status": "A",
        "authorized_official_last_name": "FARAJ",
        "authorized_official_first_name": "CHADI",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-673-5997",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MI",
            "license": "5101017213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; 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.