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EASTBORN MEDICAL GROUP PC
NPI 1306397989
Internal Medicine in Dearborn, MI

Active since October 19, 2016CLIA 23D2025608 · Waiver
15044 MICHIGAN AVE, DEARBORN, MI 48126(313) 460-9965 Get Directions Write a Review

NPPES record last updated: October 25, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 25, 2016, Oct 19, 2016 (2 updates tracked since 2016).

About Eastborn Medical Group Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EASTBORN MEDICAL GROUP PC (NPI 1306397989) is a healthcare organization registered as an internal medicine in Dearborn, Michigan and active in the NPI registry since October 2016. The organization holds a CLIA Waiver certificate valid through June 13, 2027 and lists Assem Elfakih, Owner, as its authorized official.

NPPES Registry Identity

NPI1306397989
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameEASTBORN MEDICAL GROUP PC
Location Address15044 MICHIGAN AVEDearborn, MI 48126-2914
Mailing Address15044 Michigan AveDearborn, MI 48126-2914 · (313) 460-9965
Phone(313) 460-9965
Organization SubpartNo
Authorized OfficialAssem ElfakihOwner · (313) 460-9965
Enumeration DateOctober 19, 2016
Last NPPES UpdateOctober 25, 20162 updates tracked since enumeration
✔ NPI 1306397989 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MI · 4301089499
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
15044 MICHIGAN AVE, Dearborn, MI 48126
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Eastborn Medical Group Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Eastborn Medical Group PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Assem Elfakih, M.D.
Internal Medicine
NPI 1881899946
15044 MICHIGAN AVE
Dearborn, MI 48126
(313) 406-5007
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D2025608

Eastborn Medical Group · Dearborn, MI
Active · expires Jun 13, 2027
CLIA Number23D2025608
Laboratory TypePhysician Office
Certificate Effective DateJune 14, 2025
Certificate Expiration DateJune 13, 2027
Laboratory DirectorAssem Elfakih
Laboratory Phone(313) 406-5007
Laboratory LocationEastborn Medical Group15044 Michigan Avenue, Dearborn, MI 48126
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Eastborn Medical Group PC's NPI number?

The NPI number for Eastborn Medical Group PC is 1306397989. It was assigned to this organization in the NPPES registry on October 19, 2016.

Where is Eastborn Medical Group PC located?

Eastborn Medical Group PC is located at 15044 Michigan Ave, Dearborn, MI 48126. The listed phone number is (313) 460-9965.

What is Eastborn Medical Group PC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Eastborn Medical Group PC enrolled in Medicare?

Yes. Eastborn Medical Group PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Eastborn Medical Group PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to Eastborn Medical Group PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Eastborn Medical Group PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2025608) is associated with this NPI, valid through June 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Eastborn Medical Group PC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Eastborn Medical Group PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Eastborn Medical Group PC was last updated on October 25, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.