NPIMap

Individual provider Active NPI

John S Zazaian, DO

  • Internal Medicine Physician
  • Waterford, MI
National Provider Identifier
1871581934
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101008304 Issued in MI
Practice address
1012 W Huron St
Waterford, MI 48328-3730
Phone
(248) 681-1880
Fax
(248) 681-3698
NPI assigned
Oct 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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 5101008304 MI Primary

Addresses

Primary practice location

1012 W Huron St
Waterford, MI 48328-3730

Mailing address

1012 W Huron St
Waterford, MI 48328-3730
Phone (248) 681-1880

Other identifiers 1

IdentifierTypeStateIssuer
165392311MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040303000023 MI Practitioner - Internal Medicine 8820985971 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Internal Medicine Associates,P.C.Group PAC ID 8426154865, 5 clinicians
Apollo Hospitalist GroupGroup PAC ID 5193194033, 15 clinicians

Practice addresses (Care Compare)

1012 W Huron St
Waterford, MI 48328-3730
Phone (248) 681-1880

5823 Middlebelt Rd
Garden City, MI 48135-2459
Phone (734) 421-6333

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Apollo Hospitalist Group CurrentSince Jan 1, 2023 Accepting new patients
Apollo Family Health Services PC Internal Medicine CurrentSince Jan 1, 2023 Accepting new patients
Oakland Manor Nursing & Rehab Center LLC Past Accepting new patients
Oakwood Healthcare, Inc. Past Accepting new patients
McLaren Oakland Past Accepting new patients
Hospital Health Care Inc. Internal Medicine Past Accepting new patients

Locations

5823 Middlebelt Rd
Garden City, MI 48135
Phone (734) 421-6333

6245 Inkster Rd
Garden City, MI 48135
Phone (734) 421-3300

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CFHEBA

Organizations & group practices 7

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 7

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": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1871581934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 W HURON ST",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283730",
            "telephone_number": "248-681-1880",
            "fax_number": "248-681-3698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 W HURON ST",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283730",
            "telephone_number": "248-681-1880",
            "fax_number": "248-681-3698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAZAIAN",
        "first_name": "JOHN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101008304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165392311",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

Verify at the official NPI Registry.