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PELHAM PRIMARY CARE PC
NPI 1336665728
Internal Medicine in Dearborn, MI

Active since August 17, 2017CLIA 23D2155592 · Waiver
3815 PELHAM ST, DEARBORN, MI 48124(313) 789-7636(313) 789-7018 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 21, 2022, Aug 17, 2017 (2 updates tracked since 2017).

About Pelham Primary Care Pc NPPES

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

PELHAM PRIMARY CARE PC (NPI 1336665728) is a healthcare organization registered as an internal medicine in Dearborn, Michigan and active in the NPI registry since August 2017. The organization holds a CLIA Waiver certificate valid through October 1, 2026 and lists Ribhi Hazin, Partner, as its authorized official.

NPPES Registry Identity

NPI1336665728
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NamePELHAM PRIMARY CARE PC
Location Address3815 PELHAM STDearborn, MI 48124-3852
Mailing Address3815 Pelham StDearborn, MI 48124-3852 · (313) 789-7636 · Fax (313) 789-7018
Phone(313) 789-7636
Fax(313) 789-7018
Organization SubpartNo
Authorized OfficialRibhi HazinPartner · (313) 789-7636
Enumeration DateAugust 17, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1336665728 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
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.
3815 PELHAM ST, Dearborn, MI 48124
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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 ›

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 23D2155592

Pelham Primary Care · Dearborn, MI
Active · expires Oct 1, 2026
CLIA Number23D2155592
Laboratory TypePhysician Office
Certificate Effective DateOctober 2, 2024
Certificate Expiration DateOctober 1, 2026
Laboratory DirectorTalal Khader
Laboratory Phone(313) 789-7635
Laboratory LocationPelham Primary Care3815 Pelham Street Suite 7, Dearborn, MI 48124
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEBA SOBH PHARMD
Pharmacist
3815 PELHAM ST
DEARBORN, MI 48124
Wayne County (313) 429-0470
ANDREW L. MARCUS, M.D.,P.C.
Psychiatry & Neurology (Neurology)
3815 PELHAM ST, SUITE 14
DEARBORN, MI 48124
Wayne County (313) 730-9100
DR. SUHEB MASHKOOR HASAN MD
Psychiatry & Neurology (Neurology)
3815 PELHAM ST, STE 1
DEARBORN, MI 48124
Wayne County (313) 593-3915
RANA RKEIN
Physician Assistant
3815 PELHAM ST
DEARBORN, MI 48124
Wayne County (313) 722-4683
DR. JAMES DAVID GERARD DDS
Dentist (General Practice)
3815 PELHAM ST, SUITE 11
DEARBORN, MI 48124
Wayne County (313) 565-0922
DR. AUDREY MARLA GERARD D.D.S.
Dentist (General Practice)
3815 PELHAM ST, SUITE 11
DEARBORN, MI 48124
Wayne County (313) 565-0922
DR. ANDREW L MARCUS M.D.
Psychiatry & Neurology (Neurology)
3815 PELHAM ST, SUITE 14
DEARBORN, MI 48124
Wayne County (313) 730-9100
NEUROLOGY CARE CENTER PC
Psychiatry & Neurology (Neuromuscular Medicine)
3815 PELHAM ST
DEARBORN, MI 48124
Wayne County (313) 593-3915

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 Pelham Primary Care PC's NPI number?

The NPI number for Pelham Primary Care PC is 1336665728. It was assigned to this organization in the NPPES registry on August 17, 2017.

Where is Pelham Primary Care PC located?

Pelham Primary Care PC is located at 3815 Pelham St, Dearborn, MI 48124. The listed phone number is (313) 789-7636.

What is Pelham Primary Care PC's specialty?

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

Does Pelham Primary Care PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2155592) is associated with this NPI, valid through October 1, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Pelham Primary Care 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 Pelham Primary Care 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 Pelham Primary Care PC was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.