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JIRIES ISSA HADDAD DO
NPI 1619761855
Student in an Organized Health Care Education/Training Program in Southfield, MI

Active since April 04, 2025PECOS Enrolled
22250 PROVIDENCE DR STE 301, SOUTHFIELD, MI 48075(248) 849-3281 Get Directions Write a Review

NPPES record last updated: April 4, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Jiries Issa Haddad Do NPPES

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

JIRIES ISSA HADDAD DO (NPI 1619761855) is an individual student in an organized health care education/training program in Southfield, Michigan and active in the NPI registry since April 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619761855
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJIRIES ISSA HADDADCredential: DO
Location Address22250 PROVIDENCE DR STE 301Southfield, MI 48075-6211
Mailing Address22250 Providence Dr Ste 301Southfield, MI 48075-6211 · (248) 849-3281
Phone(248) 849-3281
Sole ProprietorNo
Enumeration DateApril 4, 2025
NPPES CertifiedApril 4, 2025
✔ NPI 1619761855 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

22250 PROVIDENCE DR STE 301, Southfield, MI 48075
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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)

Jiries Issa Haddad Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 12

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

JEREMY REID HEFFERNAN M.D.
Internal Medicine
22250 PROVIDENCE DR STE 301
SOUTHFIELD, MI 48075
Oakland County (248) 849-3281
JACOB ALEX
Student in an Organized Health Care Education/Training Program
22250 PROVIDENCE DR STE 301
SOUTHFIELD, MI 48075
Oakland County (248) 849-4818
MR. AMMAR WADI ALKHAFAJI MD
Internal Medicine
22250 PROVIDENCE DR STE 301
SOUTHFIELD, MI 48075
Oakland County (248) 849-3281
PATRICK MICHAEL LAZARCZYK DO
Internal Medicine
22250 PROVIDENCE DR STE 301
SOUTHFIELD, MI 48075
Oakland County (248) 849-3281
DR. MICHAEL THOMAS CONVERTINO MD
Student in an Organized Health Care Education/Training Program
22250 PROVIDENCE DR STE 301
SOUTHFIELD, MI 48075
Oakland County (248) 849-3281
SALAM BRIKHO M.D., M.S.
General Practice
22250 PROVIDENCE DR STE 301
SOUTHFIELD, MI 48075
Oakland County (248) 849-3281
MASTER MEDICAL, PLLC
Internal Medicine
22250 PROVIDENCE DR STE 301
SOUTHFIELD, MI 48075
Oakland County (248) 849-3281
DR. ABHISHEK SUSHIL SHASTRY DO
Internal Medicine
22250 PROVIDENCE DR STE 301
SOUTHFIELD, MI 48075
Oakland County (248) 849-3281

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 Jiries Haddad's NPI number?

The NPI number for Jiries Haddad is 1619761855. It was assigned to this individual provider in the NPPES registry on April 4, 2025.

Where is Jiries Haddad located?

Jiries Haddad practices at 22250 Providence Dr Ste 301, Southfield, MI 48075. The listed phone number is (248) 849-3281.

What is Jiries Haddad's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jiries Haddad enrolled in Medicare?

Yes. Jiries Haddad is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jiries Haddad was last updated on April 4, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.