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EASTLAKE CARDIOVASCULAR PC
NPI 1982657474
Internal Medicine - Cardiovascular Disease in St Clair Shores, MI

Active since May 18, 2006
24211 LITTLE MACK AVE, ST CLAIR SHORES, MI 48080(586) 498-0440(586) 498-0401 Get Directions Write a Review

NPPES record last updated: December 1, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Eastlake Cardiovascular Pc NPPES

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

EASTLAKE CARDIOVASCULAR PC (NPI 1982657474) is a healthcare organization registered as a cardiovascular disease in St Clair Shores, Michigan and active in the NPI registry since May 2006. The organization lists George B Ghanem, President, as its authorized official.

NPPES Registry Identity

NPI1982657474
Entity TypeOrganization
Primary Taxonomy207RC0000X
Legal Business NameEASTLAKE CARDIOVASCULAR PC
Location Address24211 LITTLE MACK AVESt Clair Shores, MI 48080-1190
Mailing Address24211 Little Mack AveSt Clair Shores, MI 48080-1190 · (586) 498-0440 · Fax (586) 498-0401
Phone(586) 498-0440
Fax(586) 498-0401
Organization SubpartNo
Authorized OfficialGeorge B GhanemPresident · (586) 498-0440
Enumeration DateMay 18, 2006
Last NPPES UpdateDecember 1, 2020
NPPES CertifiedDecember 1, 2020
✔ NPI 1982657474 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
24211 LITTLE MACK AVE, St Clair Shores, MI 48080
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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)

Eastlake Cardiovascular Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

26

Medicare enrollment records show 26 clinicians reassign Medicare billing to Eastlake Cardiovascular PC, which bills Medicare for the services they deliver. Of these, 11 practice at this address and 17 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 5

Cardiovascular Disease (Cardiology)10
Nurse Practitioner6
Interventional Cardiology5
Internal Medicine4
Cardiac Electrophysiology1

Nearest to this location (20)

See all 26
Anthony Kawa, DO
Cardiovascular Disease (Cardiology)
NPI 1881643955
24211 LITTLE MACK AVE
St Clair Shores, MI 48080
(586) 498-0440
✔ PECOS✔ Accepts MedicareSame address
Brilio Mojares, MD
Interventional Cardiology
NPI 1952350126
24211 LITTLE MACK AVE
St Clair Shores, MI 48080
(586) 498-0440
✔ PECOS✔ Accepts MedicareSame address
Edouard Daher, M.D.
Interventional Cardiology
NPI 1770515504
24211 LITTLE MACK AVE
Saint Clair Shores, MI 48080
(586) 498-0440
✔ PECOS✔ Accepts MedicareSame address
Thomas Davis, MD
Interventional Cardiology
NPI 1184673303
24211 LITTLE MACK AVE
St Clair Shores, MI 48080
(586) 498-0440
✔ PECOS✔ Accepts MedicareSame address
George Ghanem, MD
Cardiovascular Disease (Cardiology)
NPI 1104899269
24211 LITTLE MACK AVE
St Clair Shores, MI 48080
(586) 498-0440
✔ PECOS✔ Accepts MedicareSame address
Marc Gosselin, DO
Interventional Cardiology
NPI 1508814989
24211 LITTLE MACK AVE
St Clair Shores, MI 48080
(586) 498-0440
✔ PECOS✔ Accepts MedicareSame address
Zaid Kasmikha, D.O.
Internal Medicine
NPI 1083902761
24211 LITTLE MACK AVE
Saint Clair Shores, MI 48080
(586) 498-0440
✔ PECOS✔ Accepts MedicareSame address
Thomas Lalonde, MD
Interventional Cardiology
NPI 1497704191
24211 LITTLE MACK AVE
St Clair Shores, MI 48080
(586) 498-0440
✔ PECOS✔ Accepts MedicareSame address
David Rodriguez, M.D.
Cardiovascular Disease (Cardiology)
NPI 1306963335
24211 LITTLE MACK AVE
Saint Clair Shores, MI 48080
(586) 498-0440
✔ PECOS✔ Accepts MedicareSame address
Georges Ghafari, MD
Cardiovascular Disease (Cardiology)
NPI 1699725606
24211 LITTLE MACK AVE
St Clair Shores, MI 48080
(586) 498-0440
✔ PECOS✔ Accepts MedicareSame address
Marni Young, NP
Nurse Practitioner
NPI 1790832319
24211 LITTLE MACK AVE
Saint Clair Shores, MI 48080
(586) 498-0440
✔ PECOS✔ Accepts MedicareSame address
Douglas Moore, D.O.
Cardiac Electrophysiology
NPI 1194729053
25195 KELLY RD STE A
Roseville, MI 48066
(586) 775-4594
✔ PECOS✔ Accepts Medicare1.1 mi
Rami Zein, D.O
Internal Medicine
NPI 1134531098
22101 MOROSS RD PROFESSIONAL BUILDING 2 SUITE 50
Detroit, MI 48236
(313) 343-7784
✔ PECOS✔ Accepts Medicare3.8 mi
Heather Franke, D.O.
Cardiovascular Disease (Cardiology)
NPI 1861710154
11885 E 12 MILE RD STE 300A
Warren, MI 48093
(586) 582-6630
✔ PECOS✔ Accepts Medicare5.4 mi
Crystal Marsh, D.O.
Internal Medicine
NPI 1528472123
11885 E 12 MILE RD STE 300A
Warren, MI 48093
(586) 582-6630
✔ PECOS✔ Accepts Medicare5.4 mi
Simone Cowan, D.O.
Cardiovascular Disease (Cardiology)
NPI 1194987826
16815 E JEFFERSON AVE STE 110
Grosse Pointe, MI 48230
(313) 640-7220
✔ PECOS✔ Accepts Medicare6.4 mi
Basil Dudar, MD
Cardiovascular Disease (Cardiology)
NPI 1407804958
16815 E JEFFERSON AVE STE 240
Grosse Pointe, MI 48230
(313) 473-4690
✔ PECOS✔ Accepts Medicare6.4 mi
Kathryn Lewis
Nurse Practitioner
NPI 1649528076
15855 19 MILE RD
Clinton Twp, MI 48038
(800) 532-2411
✔ PECOS10 mi
Joel Skaistis, M.D.
Internal Medicine
NPI 1932462637
3601 W 13 MILE RD
Royal Oak, MI 48073
(248) 551-3000
✔ PECOS✔ Accepts Medicare15 mi
Michael Tucciarone, M.D.
Cardiovascular Disease (Cardiology)
NPI 1427267525
2061 W AUBURN RD
Rochester, MI 48307
(248) 923-2002
✔ PECOS✔ Accepts Medicare17 mi
See all 26 clinicians

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

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 Eastlake Cardiovascular PC's NPI number?

The NPI number for Eastlake Cardiovascular PC is 1982657474. It was assigned to this organization in the NPPES registry on May 18, 2006.

Where is Eastlake Cardiovascular PC located?

Eastlake Cardiovascular PC is located at 24211 Little Mack Ave, St Clair Shores, MI 48080. The listed phone number is (586) 498-0440.

What is Eastlake Cardiovascular PC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Eastlake Cardiovascular PC enrolled in Medicare?

Yes. Eastlake Cardiovascular PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Eastlake Cardiovascular PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 26 clinicians in 5 Medicare specialties reassign their Medicare billing to Eastlake Cardiovascular 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. The largest specialties are Cardiovascular Disease (Cardiology) (10), Nurse Practitioner (6) and Interventional Cardiology (5). Of these, 11 practice at this address and 17 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Eastlake Cardiovascular 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 Eastlake Cardiovascular 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 Eastlake Cardiovascular PC was last updated on December 1, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.