NPIMap

Organization Active NPI

Elite Care Physicians, PLLC

  • Primary Care Clinic/Center
  • Redford, MI
National Provider Identifier
1982830535
Registry record updated Jul 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
ELITE CARE PHYSICIANS, PLLC
Practice address
27144 Joy Rd
Redford, MI 48239-2368
Phone
(313) 410-6003
Fax
(313) 937-1402
NPI assigned
Jun 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2015

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

Authorized official

Name
Dr. Hadi A Dourra, M.DNPI 1003975517
Title
Medical Director
Phone
(313) 410-6003

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

27144 Joy Rd
Redford, MI 48239-2368

Mailing address

27144 Joy Rd
Redford, MI 48239-2368
Phone (313) 410-6003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091008000410 MI Part B Supplier - Clinic/Group Practice 9133265945 Receives reassigned benefits from 3 practitioners
Practice locations: Allen Park, MI; Canton, MI; Detroit, MI; Redford, MI

National Provider Directory

National Provider Directory

Locations

8542 N Canton Center Rd
Canton, MI 48187
Phone (313) 974-6533

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436313600000",
    "number": "1982830535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27144 JOY RD",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482392368",
            "telephone_number": "313-410-6003",
            "fax_number": "313-937-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27144 JOY RD",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482392368",
            "telephone_number": "313-410-6003",
            "fax_number": "313-937-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE CARE PHYSICIANS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-09",
        "last_updated": "2015-07-08",
        "status": "A",
        "authorized_official_last_name": "DOURRA",
        "authorized_official_first_name": "HADI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "313-410-6003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.