Individual provider Active NPI

Rida Ahamd Barakat

  • Family Medicine Physician
  • Dearborn, MI
National Provider Identifier
1932761467
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301505972 Issued in MI
Practice address
13700 Michigan Ave
Dearborn, MI 48126-3489
Phone
(313) 551-5134
Fax
(313) 551-5136
NPI assigned
Jul 4, 2019
Last updated
Oct 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301505972 MI Primary

Addresses

Primary practice location

13700 Michigan Ave
Dearborn, MI 48126-3489

Mailing address

13700 Michigan Ave
Dearborn, MI 48126-3489
Phone (313) 551-5134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20231103001112 MI Practitioner - Family Practice 4082074554 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
International Medical Group PLLCGroup PAC ID 3375995046, 2 clinicians
Prime Family Care LLCGroup PAC ID 0446605018, 2 clinicians

Practice addresses (Care Compare)

15301 Tireman Ave
Suite a
Dearborn, MI 48126-1045
Phone (313) 358-6586

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301505972MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Dearborn Urgent Care PC Current Accepting new patients
Prime Family Care LLC CurrentSince Nov 1, 2023 Accepting new patients
International Medical Group PLLC CurrentSince Sep 1, 2023 Accepting new patients
Vegas Medical Center PC Family Medicine Current Accepting new patients

Locations

13700 Michigan Ave
Dearborn, MI 48126
Phone (313) 551-5134

15301 Tireman Ave
Ste A
Dearborn, MI 48126
Phone (313) 358-6586

15301 Tireman Ave
Ste B
Dearborn, MI 48126
Phone (313) 358-6586

20219 Carlysle St
Ste B
Dearborn, MI 48124
Phone (313) 358-6586

Interoperability endpoints

  • Direct secure messaging: rbarakat1014826@direct.hfhs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1562198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1932761467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13700 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263489",
            "telephone_number": "313-551-5134",
            "fax_number": "313-551-5136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13700 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263489",
            "telephone_number": "313-551-5134",
            "fax_number": "313-551-5136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARAKAT",
        "first_name": "RIDA",
        "middle_name": "AHAMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-04",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301505972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.