George Ibrahim Fakhouri, DO

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

5101025718 Issued in MI

Practice address

36385 Harper Ave
Clinton TWP, MI 48035-2958

Phone

(586) 684-1900

NPI assigned

Jul 3, 2018

Sex

Male

Sole proprietor

No

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.

• Michigan MSK Medicine PLLC

  • Neuromusculoskeletal Medicine & OMM Physician
  • Clinton Township, MI
  • NPI 1578148375

  MI, Neuromusculoskeletal Medicine, Sports Medicine

  Medicare reassignment Care Compare group NPD
• Edward W. Sparrow Hospital Association

  • Pediatrics Physician
  • Lansing, MI
  • NPI 1831139088

  MI

  Medicare reassignment NPD
• Edward W Sparrow Hospital Association

  • Adult Health Nurse Practitioner
  • Lansing, MI
  • NPI 1265220438

  Family Medicine

  NPD
• Edward W. Sparrow Hospital Association

  • Family Medicine Physician
  • Mason, MI
  • NPI 1083668545

  Family Medicine

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• McLaren Macomb

  • Psychiatric Hospital Unit
  • Shelby Township, MI
  • NPI 1184206385

  Hospital

  Care Compare affiliation
• McLaren Macomb

  • General Acute Care Hospital
  • Mount Clemens, MI
  • NPI 1316938327

  Hospital

  Care Compare affiliation

Specialty

Sports MedicineAlso: Osteopathic Manipulative Medicine

Education

Michigan State University College of Osteopathic Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Michigan MSK Medicine PLLC 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• McLaren Macomb Hospital, Mount Clemens, MI, CCN 230227

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gfakhouri413172@direct.hfhs.org

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 9, 2023.

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1992291900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36385 HARPER AVE",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480352958",
            "telephone_number": "586-684-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36385 HARPER AVE",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480352958",
            "telephone_number": "586-684-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKHOURI",
        "first_name": "GEORGE",
        "middle_name": "IBRAHIM",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-03",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "MI",
            "license": "5101025718",
            "primary": false
        },
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MI",
            "license": "5101025718",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MI",
            "license": "5101025718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Ewald, LMSW
• Tricia Lynn Fabbri, NP
• Adam Mohamed Fahs
• Heather Lee Fairless, O.D.
• Ben Fajardo, M.D.
• Family Chiropractor P.C.
• Family Medicine Associates of Macomb PC
• Family Practice Physicians
• Fedor Opochinsky M.D.
• Christina M. Felcyn, MA, LPC, NCC

• All providers in Clinton TWP, MI
• Sports Medicine (Family Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.

Verify at the official NPI Registry.