Henry Ford Wyandotte Hospital
Organization Active NPI General Acute Care Hospital · Wyandotte, MI
NPI 1992725352 · NPPES record last updated Mar 6, 2024
Key facts
- NPI
- 1992725352
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Acute Care Hospital 282N00000X
- License
- 820230 (MI)
- Legal business name
- HENRY FORD WYANDOTTE HOSPITAL
- Practice address
- 2333 Biddle Ave
Wyandotte, MI 48192-4668 - Phone
- (734) 246-6000
- Fax
- (734) 246-6986
- NPI assigned
- Jul 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Robin S. Damschroder
- Title
- Evp, Chief Fin & Bus Dev Officer
- Phone
- (313) 876-8452
Owners & managing parties with NPI records 2
-
Farzan Siddiqui, M.D., PH.D.
-
Lisa Fitzpatrick, MD, MPH
Other NPIs on the same Medicare enrollment 4
Other NPIs with the same Medicare PAC ID 8
Member of 1
Related certifications (CCN) 2
Facilities with the same owner 159
Practitioners 256
-
Louis Andary Jr., MD
-
Muhannad Antoun, M.D
-
Habeeb A Bello, D.O
-
Kathryn Shannon Maloy, M.D., MPH
-
Sophia I Mehboob, M.D.
-
Glenn J Minster, M.D.
-
Michael David Reaume, M.D.
-
Christina Gough Wood, D.O.
-
Ameen Abdulmalik, M.D
-
Justin Adams, D.O.
-
Oussama Al Sawas, M.D.
-
Waleed Al-Darzi, M.D.
-
Munther K Alaiwat, M.D.
-
Adam Nagib Ali, MD
-
Abdulwahhab Alroaini, M.D.
-
Hayley Jo Altshuler, PA-C
-
Jessica Lynn Baginski, MSN, RN, AGACNP-BC
Affiliated clinicians 842
-
Khaled Abdul-Nour, M.D.
-
Ameen Abdulmalik, M.D
-
Fawzi Abu Rous, MD
-
Majd Aburabia, M.D.
-
Ali Alexandru Achira, M.D
-
Bernard Angello Acho, M.D.
-
Justin Adams, D.O.
-
Nicole Adams, D.O.
-
Nazia Sadaf Adil, MD
-
Alka Aggarwal, M.D.
-
Ahmad M Ahmad, MD
-
Faisal Imtiaz Ahmad, M.D.
-
Omar Imtiaz Ahmad, M.D.
-
Beena Ahsan, M.D
-
Syed M. Ahsan, M.D.
Medicare Care Compare: Hospital
- Listed as
- Wyandotte Hospital and Medical Center
- Overall star rating
- ★★☆☆☆ 2 of 5
- Type
- Acute Care Hospitals
- Ownership
- Voluntary non-profit - Private
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI
Hospital certification: CCN 230146
- Legal name
- HENRY FORD WYANDOTTE HOSPITAL
- Doing business as
- WYANDOTTE HOSPITAL AND MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Sep 12, 2012
- Beds
- 345
- Ownership / control type
- Private (not for profit)
- Most recent change of ownership
- May 1, 1988 (2 total)
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 2333 Biddle Ave
Wyandotte, MI 48192-4668 - Hospital subgroups
- Acute care
All disclosed owners & managing parties 31
| Name | Role | Since | Share |
|---|---|---|---|
| Daniel J. Phelan |
Corporate Director | Jan 1, 2022 | |
| Henry Ford Health System |
5% Or Greater Direct Ownership Interest | Dec 18, 1987 | 100% |
| Charles McClure |
Corporate Director | Jan 1, 2020 | |
| Robert R Lubera |
Corporate Director |
Sep 1, 2025 | |
| Barry G. Porter |
Corporate Director | Jan 1, 2020 | |
| Steven Brian Bender |
Corporate Officer |
Oct 21, 2024 | |
| Gerardo Norcia |
Corporate Director | Dec 1, 2023 | |
| Robert Riney |
Corporate Director | Jul 1, 2022 | |
| Michael Rafferty |
Corporate Director | Jan 1, 2020 | |
| Jeffrey Fall |
Corporate Director |
Sep 1, 2025 | |
| Farzan Siddiqui |
Corporate Director | Jan 1, 2024 | |
| Marjorie Staten |
Corporate Officer | Jan 1, 2019 | |
| Rhonda M Medows |
Corporate Director |
Sep 1, 2025 | |
| David Breen |
Corporate Director | Jan 1, 2015 | |
| Mary Ann Victor |
Corporate Director |
Sep 1, 2025 | |
| Jason Williams |
Corporate Officer |
Oct 1, 2024 | |
| Anthony Rocco Tersigni |
Corporate Director | Oct 1, 2024 | |
| Robin S. Damschroder |
Corporate Officer | Jan 1, 2018 | |
| Calvin R Ford |
Corporate Director |
Jan 1, 2025 | |
| Robert Young |
W-2 Managing Employee | Jan 1, 2020 | |
| Gregory Pflum |
Corporate Director |
Sep 1, 2025 | |
| Henry Ford Health Parent |
5% Or Greater Indirect Ownership Interest | Oct 1, 2024 | 80% |
| Edward D Callaghan |
Corporate Director |
Sep 1, 2025 | |
| John F. Harris |
Corporate Director | Jan 1, 2021 | |
| Ascension Health |
5% Or Greater Indirect Ownership Interest | Oct 1, 2024 | 20% |
| Edgar Vann |
Corporate Director | Jan 1, 2015 | |
| Lisa Fitzpatrick |
Corporate Director |
Sep 1, 2025 | |
| Joseph Richardson |
Corporate Director | Jan 1, 2016 | |
| Gwendolyn M Mackenzie |
Corporate Director |
Sep 1, 2025 | |
| Jacalyn S. Goforth |
Corporate Director | Jan 1, 2022 | |
| Eugene F Lovasco |
Corporate Director | Oct 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040227000431 | MI | Part B Supplier - Clinic/Group Practice | 2264334499 |
Receives reassigned benefits from 245 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Rockwood, MI; Wyandotte, MI; Trenton, MI; Southgate, MI; Novi, MI; Brownstown TWP, MI; Allen Park, MI |
| O20071210000516 | MI | Part a Provider - Hospital | 2264334499 |
1 other NPI on this enrollment Practice locations: Brownstown TWP, MI; Wyandotte, MI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | 820230 | MI | Yes |
Addresses
Primary practice location
2333 Biddle Ave
Wyandotte, MI 48192-4668
Mailing address
2333 Biddle Ave
Wyandotte, MI 48192-4668
Phone (734) 246-6000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00285 | Other | MI | BLUE CROSS |
| 301892495 | Medicaid | MI |
Other names
- Wyandotte Hospital and Medical Center
Other providers in Wyandotte, MI
- Henry Ford Wyandotte Hospital
- Henry Ford Wyandotte Hospital
- Henry Ford Wyandotte Hospital
- Henry Ford Wyandotte Hospital
- Henry Ford Wyandotte Hospital
- Alexis Alicia Hernandez
- Rima Hijazi
- Meredith Colleen Hill
- Barbara J Hills
- Alex Patrick Hinken
All providers in Wyandotte, MI · General Acute Care Hospital 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.