Individual provider Active NPI

Eman Bazzi

  • Family Medicine Physician
  • Dearborn, MI
National Provider Identifier
1871155622
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4351045569 Issued in MI
Practice address
856 Claremont St
Dearborn, MI 48124
Phone
(313) 461-5345
NPI assigned
Jul 2, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X T3925 TX
Family Medicine Physician 207Q00000X 4351045569 MI Primary

Addresses

Primary practice location

856 Claremont St
Dearborn, MI 48124

Mailing address

856 Claremont St
Dearborn, MI 48124-1520
Phone (313) 461-5345

Other practice location 1

5282 Medical Dr Ste 250
San Antonio, TX 78229-6039
Phone (210) 358-8820

Other practice location 2

1102 Barclay St
San Antonio, TX 78207-7161
Phone (210) 233-7000

Other practice location 3

21400 E 11 Mile Rd
Saint Clair Shores, MI 48081-1566
Phone (586) 498-4400

Other practice location 4

468 Cadieux Rd
Grosse Pointe, MI 48230-1507
Phone (313) 473-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220615003126 TX Practitioner - Family Practice 9335474105 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medicine Associates Family Medicine CurrentSince Jun 7, 2022 Accepting new patients

Locations

903 W Martin St
#492
San Antonio, TX 78207
Phone (210) 358-3441

21727 W Interstate 10
San Antonio, TX 78257
Phone (210) 455-1091

5282 Medical Dr
Ste 250
San Antonio, TX 78229
Phone (210) 358-8820

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1871155622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 CLAREMONT ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241520",
            "telephone_number": "313-461-5345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "856 CLAREMONT ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "48124",
            "telephone_number": "313-461-5345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5282 Medical Dr Ste 250",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782296039",
            "country_code": "US",
            "telephone_number": "210-358-8820",
            "fax_number": "210-358-9434",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1102 Barclay St",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782077161",
            "country_code": "US",
            "telephone_number": "210-233-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21400 E 11 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Clair Shores",
            "state": "MI",
            "postal_code": "480811566",
            "country_code": "US",
            "telephone_number": "586-498-4400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "468 Cadieux Rd",
            "address_purpose": "LOCATION",
            "city": "Grosse Pointe",
            "state": "MI",
            "postal_code": "482301507",
            "country_code": "US",
            "telephone_number": "313-473-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAZZI",
        "first_name": "EMAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T3925",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4351045569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.