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Individual provider Active NPI

Tarif Hussein Mustafa Sr., MD

  • Internal Medicine Physician
  • Dearborn, MI
National Provider Identifier
1902870470
Registry record updated Sep 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301057882 Issued in MI
Practice address
12940 W Warren
Warren Medical Center
Dearborn, MI 48126
Phone
(313) 945-8210
Fax
(313) 945-0729
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2009

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 4301057882 MI Primary

Addresses

Primary practice location

12940 W Warren
Warren Medical Center
Dearborn, MI 48126

Mailing address

12940 W Warren
Dearborn, MI 48126
Phone (313) 945-8210

Other identifiers 1

IdentifierTypeStateIssuer
2751061MedicaidMI

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
I20040920000615 MI Practitioner - Internal Medicine 9032187984 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
West Detroit Urgent Center PLLCGroup PAC ID 2365976990, 2 clinicians

Practice addresses (Care Compare)

12940 W Warren Ave
Warren Medical Center
Dearborn, MI 48126-1535
Phone (313) 945-8210

18435 Plymouth Rd
Detroit, MI 48228-1125
Phone (313) 673-8226

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
West Detroit Urgent Center PLLC CurrentSince Oct 1, 2024 Accepting new patients
Tarif Mustafa MD PC Internal Medicine CurrentSince Oct 15, 2010 Accepting new patients
Satinder Kumar Aggarwal MD P C Internal Medicine Past Accepting new patients
Millennium Medical Group South PC Internal Medicine PastSince Oct 16, 2010 Accepting new patients

Locations

12940 W Warren Ave
Dearborn, MI 48126
Phone (313) 945-8210

18435 Plymouth Rd
Detroit, MI 48228
Phone (313) 484-1000

7649 W Vernor Hwy
Detroit, MI 48209
Phone (313) 433-1208

Organizations & group practices 4

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.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254182400000",
    "number": "1902870470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12940 W WARREN",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "48126",
            "telephone_number": "313-945-8210",
            "fax_number": "313-945-0729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12940 W WARREN",
            "address_2": "WARREN MEDICAL CENTER",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "48126",
            "telephone_number": "313-945-8210",
            "fax_number": "313-945-0729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSTAFA",
        "first_name": "TARIF",
        "middle_name": "HUSSEIN",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2009-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301057882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2751061",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.