PRIME CARE MEDICAL CLINIC PLLC
NPI 1861702433
Internal Medicine in Dearborn, MI
About Prime Care Medical Clinic Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PRIME CARE MEDICAL CLINIC PLLC (NPI 1861702433) is a healthcare organization registered as an internal medicine in Dearborn, Michigan and active in the NPI registry since October 2010. The organization holds a CLIA Waiver certificate valid through July 17, 2027 and lists Fouad A Dakhlallah, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Prime Care Medical Clinic Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
8Medicare enrollment records show 8 clinicians reassign Medicare billing to Prime Care Medical Clinic PLLC, which bills Medicare for the services they deliver. Of these, 8 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (8)
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 23D2062550
Primecare Medical Clinic PLLC · Dearborn, MIFrequently 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 Prime Care Medical Clinic PLLC's NPI number?
The NPI number for Prime Care Medical Clinic PLLC is 1861702433. It was assigned to this organization in the NPPES registry on October 18, 2010.
Where is Prime Care Medical Clinic PLLC located?
Prime Care Medical Clinic PLLC is located at 13840 W Warren Ave, Dearborn, MI 48126. The listed phone number is (313) 581-8080.
What is Prime Care Medical Clinic PLLC's specialty?
The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.
Is Prime Care Medical Clinic PLLC enrolled in Medicare?
Yes. Prime Care Medical Clinic PLLC is registered in the Medicare PECOS enrollment system.
When is Prime Care Medical Clinic PLLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Michigan, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Prime Care Medical Clinic PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 4 Medicare specialties reassign their Medicare billing to Prime Care Medical Clinic PLLC. 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. The largest specialties are Nurse Practitioner (4), Internal Medicine (2) and Cardiovascular Disease (Cardiology) (1). Of these, 8 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Prime Care Medical Clinic PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 23D2062550) is associated with this NPI, valid through July 17, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Prime Care Medical Clinic PLLC 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 Prime Care Medical Clinic PLLC 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 Prime Care Medical Clinic PLLC was last updated on December 1, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Prime Care Medical Clinic Pllc · NPI 1861702433
Internal Medicine organization in Dearborn, Michigan. Organization record, active in the CMS NPPES registry since October 18, 2010.
## Identity
- **NPI:** 1861702433 (Entity type: Organization)
- **Enumerated:** October 18, 2010
- **Primary specialty:** Internal Medicine · taxonomy 207R00000X
- **Organization subpart:** No
- **Authorized official:** Fouad Dakhlallah, OWNER
## Practice location
- **Address:** 13840 W WARREN AVE, Dearborn, MI 48126-1425
- **Phone:** (313) 581-8080 · **Fax:** (313) 581-8383
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Michigan, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 8 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (4), Internal Medicine (2), Cardiovascular Disease (Cardiology) (1); 8 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 1, 2011
- **Other identifiers:** Medicaid 4753252 (MI)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1861702433) · Data from the CMS NPPES public registry.