Active NPI
Ali Tarif Bazzy, D.O.
- Family Medicine Physician
- Saint Clair Shores, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 5101021541
- Practice address
- 20225 E 9 Mile Rd Ste a
Saint Clair Shores, MI 48080 - Phone
- (586) 779-8700
- Fax
- (586) 498-1425
- NPI assigned
- Jun 4, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 5101021541 | MI | Primary |
Addresses
Primary practice location
20225 E 9 Mile Rd Ste a
Saint Clair Shores, MI 48080
Mailing address
20225 E 9 Mile Rd Ste a
Saint Clair Shores, MI 48080-1700
Phone (586) 779-8700
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180614000715 | MI | Practitioner - Family Practice | 4486948692 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Henry Ford Cornerstone Medical Group
Practice addresses (Care Compare)
20225 E 9 Mile Rd
Suite a
Saint Clair Shores, MI 48080-1700
Phone (586) 772-1090
43900 Garfield Rd
Suite 222
Clinton Township, MI 48038-1137
Phone (586) 286-0050
Hospital & facility affiliations
- Henry Ford Health St John Hospital
- Henry Ford Health Warren Hospital
- Beaumont Hospital - Grosse Pointe
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Cornerstone Medical Group | Family Medicine | Current | Accepting new patients |
Locations
4260 Van Dyke Rd
Ste 102
Almont, MI 48003
Phone (810) 798-3994
43900 Garfield Rd
Ste 222
Clinton Twp, MI 48038
Phone (586) 263-1234
20225 E 9 Mile Rd
Ste 100
Saint Clair Shores, MI 48080
Phone (586) 285-9600
20225 E 9 Mile Rd
Ste A
St Clr Shores, MI 48080
Phone (586) 772-1090
Interoperability endpoints
- ali.bazzy.1@8209.direct.athenahealth.com
- https://fhir-myrecord.cerner.com/r4/mQjCqHb5rkr1u1foU4dqhQPBpi7Qk9R4/
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Clinton Township, MI
- NPI 1851765374
Family Medicine, MI
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Warren, MI
- NPI 1124099858
Hospital
-
- General Acute Care Hospital
- Madison Heights, MI
- NPI 1215139233
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530576000000",
"number": "1962882910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20225 E 9 MILE RD STE A",
"city": "SAINT CLAIR SHORES",
"state": "MI",
"postal_code": "480801700",
"telephone_number": "586-779-8700",
"fax_number": "586-498-1425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20225 E 9 MILE RD STE A",
"city": "SAINT CLAIR SHORES",
"state": "MI",
"postal_code": "48080",
"telephone_number": "586-779-8700",
"fax_number": "586-498-1425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAZZY",
"first_name": "ALI",
"middle_name": "TARIF",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-04",
"last_updated": "2018-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "5101021541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Clair Shores, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.