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DIANA S KADDOUH FNP
NPI 1437021904
Nurse Practitioner - Family in Canton, MI

Active since September 23, 2025PECOS Enrolled
6300 N HAGGERTY RD STE 220, CANTON, MI 48187(734) 365-6804(734) 365-6804 Get Directions Write a Review

NPPES record last updated: October 21, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Diana S Kaddouh Fnp NPPES

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

DIANA S KADDOUH FNP (NPI 1437021904) is an individual family provider in Canton, Michigan, licensed in Michigan (4704399875) and active in the NPI registry since September 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1437021904
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameDIANA S KADDOUHCredential: FNP
Location Address6300 N HAGGERTY RD STE 220Canton, MI 48187-4472
Mailing Address6300 N Haggerty Rd Ste 220Canton, MI 48187-4472 · (734) 365-6804 · Fax (734) 365-6804
Phone(734) 365-6804
Fax(734) 365-6804
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateSeptember 23, 2025
Last NPPES UpdateOctober 21, 2025
NPPES CertifiedOctober 21, 2025
✔ NPI 1437021904 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in MI · 4704399875
6300 N HAGGERTY RD STE 220, Canton, MI 48187
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Diana S Kaddouh Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1254822265
PECOS Enrollment IDI20251118001983
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48187 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

CANTON FAMILY HEALTH LLC
Family Medicine
6300 N HAGGERTY RD STE 220
CANTON, MI 48187
Wayne County (313) 283-1019

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 Diana Kaddouh's NPI number?

The NPI number for Diana Kaddouh is 1437021904. It was assigned to this individual provider in the NPPES registry on September 23, 2025.

Where is Diana Kaddouh located?

Diana Kaddouh practices at 6300 N Haggerty Rd Ste 220, Canton, MI 48187. The listed phone number is (734) 365-6804.

What is Diana Kaddouh's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Diana Kaddouh enrolled in Medicare?

Yes. Diana Kaddouh is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Diana Kaddouh was last updated on October 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.