Organization Active NPI

Tawfiq J.Hassan MD PC

  • Internal Medicine Physician
  • Dearborn, MI
National Provider Identifier
1902120108
Registry record updated Oct 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301050895 Issued in MI
Legal business name
TAWFIQ J.HASSAN MD PC
Practice address
25325 Ford Rd
Suite 100
Dearborn, MI 48128-1086
Phone
(313) 565-1111
NPI assigned
Mar 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2010

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

Authorized official

Name
Tawfiq J Hassan, MDNPI 1144290909
Title
President
Phone
(313) 565-1111

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 4301050895 MI Primary

Addresses

Primary practice location

25325 Ford Rd
Suite 100
Dearborn, MI 48128-1086

Mailing address

25325 Ford Rd
Suite 100
Dearborn, MI 48128-1086
Phone (313) 565-1111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101012000291 MI Part B Supplier - Clinic/Group Practice 2860684602 Receives reassigned benefits from 1 practitioner
Practice locations: Dearborn, MI

National Provider Directory

National Provider Directory

Locations

1331 Monroe St
Ste 100
Dearborn, MI 48124
Phone (313) 336-7400

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": "1268784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286928000000",
    "number": "1902120108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25325 FORD RD",
            "address_2": "SUITE 100",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281086",
            "telephone_number": "313-565-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25325 FORD RD",
            "address_2": "SUITE 100",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281086",
            "telephone_number": "313-565-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAWFIQ J.HASSAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-17",
        "last_updated": "2010-10-13",
        "status": "A",
        "authorized_official_last_name": "HASSAN",
        "authorized_official_first_name": "TAWFIQ",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-565-1111",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301050895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; 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.