Individual provider Active NPI

Sina Khoshbin, M.D.

  • Surgery Physician
  • Detroit, MI
National Provider Identifier
1972890564
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
4301501095 Issued in MI
Practice address
2799 W Grand Blvd
Detroit, MI 48202-2689
Phone
(313) 916-3057
NPI assigned
Jul 1, 2011
Last updated
Apr 28, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0116023851 VA
Surgery Physician 208600000X 2016011008 MO
Surgery Physician 208600000X 4301501095 MI Primary

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202-2689

Mailing address

2799 W Grand Blvd
Detroit, MI 48202-2689
Phone (313) 916-3057

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address skhoshbin626192@direct.hfhs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190904000246 MO Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 3072817295 Reassigns benefits to 1 organization
I20200318002322 MI Practitioner - General Surgery 3072817295 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Tufts University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion16
Colonoscopy1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016011008MOMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Current Accepting new patients
Henry Ford Health System Transplant Surgery CurrentSince Jan 29, 2020 Accepting new patients
Poplar Bluff Hma Physician Management, LLC Surgery CurrentSince Jul 24, 2019 Accepting new patients
Henry Ford Health System CurrentSince Jan 29, 2020 Accepting new patients
Henry Ford Health System Past Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

2799 W Grand Blvd
#6
Detroit, MI 48202
Phone (313) 916-3879

2799 W Grand Blvd
#K8
Detroit, MI 48202
Phone (313) 916-1755

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

2333 Biddle Ave
Wyandotte, MI 48192
Phone (734) 246-6000

3098 Oak Grove Rd
Poplar Bluff, MO 63901
Phone (573) 778-2600

Interoperability endpoints

  • Direct secure messaging: skhoshbin626192@direct.hfhs.org

Organizations & group practices 5

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 1

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": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1972890564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022689",
            "telephone_number": "313-916-3057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022689",
            "telephone_number": "313-916-3057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOSHBIN",
        "first_name": "SINA",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-01",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0116023851",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MO",
            "license": "2016011008",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301501095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skhoshbin626192@direct.hfhs.org",
            "affiliation": "N",
            "endpointDescription": "HFH Direct Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2799 W Grand Blvd",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482022689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.