Southfield Medical Group PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SOUTHFIELD MEDICAL GROUP PLLC

Practice address

28500 Southfield Rd
Suite 200
Lathrup Village, MI 48076-2722

Phone

(248) 440-2185

Fax

(248) 440-2189

NPI assigned

Jun 25, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Riyadh P Kasmikha, MDNPI 1013980531

Title

President

Phone

(248) 440-2185

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Riyadh P Kasmikha, M.D.

  • Internal Medicine Physician
  • Lathrup Village, MI
  • NPI 1013980531
  Medicare reassignment NPD Authorized official
• Ayad Shawkat Jazrawi, M.D.

  • Interventional Cardiology Physician
  • Clawson, MI
  • NPI 1760605166

  Internal Medicine

  Medicare reassignment NPD
• May M Antone, MD

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1194797035
  NPD (past)
• Samira Zebari, M.D.

  • Pediatrics Physician
  • Lathrup Village, MI
  • NPI 1467548891
  NPD (past)

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881620235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28500 SOUTHFIELD RD",
            "address_2": "SUITE 200",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480762722",
            "telephone_number": "248-440-2185",
            "fax_number": "248-440-2189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28500 SOUTHFIELD RD",
            "address_2": "SUITE 200",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480762722",
            "telephone_number": "248-440-2185",
            "fax_number": "248-440-2189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHFIELD MEDICAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KASMIKHA",
        "authorized_official_first_name": "RIYADH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-440-2185",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Southfield Pain Mangement
• Southfield Pediatrics PLLC
• Specialty Medical Group (Physicians Skin Care Center)
• Spectrum Medical Equipment Inc.
• Tonja Maria Stallings, R.D.

• Internal Medicine Physician in Lathrup Village, MI
• Providers in Lathrup Village, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.