Henry Ford Health System
Organization Active NPI Cardiovascular Disease Physician · Detroit, MI
NPI 1982787487 · NPPES record last updated Mar 6, 2024
Key facts
- NPI
- 1982787487
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- 830190 (MI)
- Legal business name
- HENRY FORD HEALTH SYSTEM
- Practice address
- 2799 W Grand Blvd
Detroit, MI 48202-2608 - Phone
- (313) 916-2600
- NPI assigned
- Oct 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Mark Smith, MD
- Title
- Sr VP Cmo
- Phone
- (517) 205-6407
Other NPIs on the same Medicare enrollment 28
Corporate family (same tax ID) 15
Practitioners 94
-
Asrar Abdou, MD
-
Khaled Abdul-Nour, M.D.
-
Vikas Aggarwal, M.D.
-
Waleed Al-Darzi, M.D.
-
Khaldoon Alaswad, MD
-
Herbert David Aronow, M.D.
-
Anna Rogers Axelson, M.D.
-
Zain Azzo, M.D.
-
Mir Babar Basir, D.O.
-
Surjit S. Bhasin, MD
-
Marc Brodsky, MD
-
Morris Brown, M.D.
-
Wael Hussein Dabaja, D.O.
-
John Dawdy, M.D.
-
Samvid A Dwivedi, D.O.
-
Amjad M. Farha, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031105000139 | MI | Part B Supplier - Clinic/Group Practice | 0547178311 |
Receives reassigned benefits from 1,862 practitioners 28 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Novi, MI; Sterling Heights, MI; Southfield, MI; Saint Clair Shores, MI; Royal Oak, MI; Plymouth, MI; Northville, MI; Milford, MI… |
National Provider Directory
- Tax ID family
- Henry for Hospital
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Heart Failure and Transplant Cardiology Physician |
207RA0001X | |||
| Cardiovascular Disease Physician |
207RC0000X | 830190 | MI | Yes |
| Clinical Cardiac Electrophysiology Physician |
207RC0001X | |||
| Interventional Cardiology Physician |
207RI0011X | |||
| Pediatric Cardiology Physician |
2080P0202X |
Addresses
Primary practice location
2799 W Grand Blvd
Detroit, MI 48202-2608
Mailing address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600
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All providers in Detroit, MI · Cardiovascular Disease Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.