Individual provider Active NPI

Mohammad Ghali, MD

  • Pediatrics Physician
  • Sylvania, OH
National Provider Identifier
1023014610
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4301057489 Issued in MI
Practice address
5700 Monroe Street
Wuite 301
Sylvania, OH 43560-2737
Phone
(419) 291-2121
Fax
(419) 479-6017
NPI assigned
Jun 28, 2005
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301057489 MI Primary

Addresses

Primary practice location

5700 Monroe Street
Wuite 301
Sylvania, OH 43560-2737

Mailing address

505 N Jackson St
Jackson, MI 49201-1266
Phone (517) 748-5500

Other identifiers 1

IdentifierTypeStateIssuer
3479730-10MedicaidMI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mghali445356@direct.hfhs.org Health Information Exchange (HIE) Henry Ford Health System
Direct Messaging Address mghali24324@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070714000143 MI Practitioner - Pediatric Medicine 9931209343 Reassigns benefits to 2 organizations
I20171004003688 OH Practitioner - Pediatric Medicine 9931209343 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301057489MIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians CurrentSince Nov 1, 2017 Accepting new patients
Bell Physician Practices Inc CurrentSince Dec 13, 2016 Accepting new patients
Bell Physician Practices Inc CurrentSince Dec 13, 2016 Accepting new patients
Promedica Central Physicians CurrentSince Nov 1, 2017 Accepting new patients
Center for Family Health Pediatrics CurrentSince Sep 13, 2016 Accepting new patients
Center for Family Health Pediatrics CurrentSince Sep 13, 2016 Accepting new patients

Locations

901 Lakeshore Dr
Ishpeming, MI 49849
Phone (906) 485-2653

1024 Fleming Ave
Jackson, MI 49202
Phone (517) 748-5500

1200 N West Ave
Ste 812
Jackson, MI 49202
Phone (517) 783-4418

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

2400 4th St
Jackson, MI 49203
Phone (517) 788-6812

300 S Blackstone St
Jackson, MI 49201
Phone (517) 539-8620

505 N Jackson St
Jackson, MI 49201
Phone (517) 748-5500

6700 Rives Junction Rd
Jackson, MI 49201
Phone (517) 569-3200

5700 Monroe St
Sylvania, OH 43560
Phone (419) 473-6622

5700 Monroe St
Unit 301
Sylvania, OH 43560
Phone (419) 291-2121

1 Seagate
Ste 800
Toledo, OH 43604

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

Interoperability endpoints

  • Direct secure messaging: mghali24324@direct.promedica.org
  • Direct secure messaging: mghali445356@direct.hfhs.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1023014610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N JACKSON ST",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011266",
            "telephone_number": "517-748-5500",
            "fax_number": "517-780-9286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 MONROE STREET",
            "address_2": "WUITE 301",
            "city": "SYLVANIA",
            "state": "OH",
            "postal_code": "435602737",
            "telephone_number": "419-291-2121",
            "fax_number": "419-479-6017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHALI",
        "first_name": "MOHAMMAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2023-11-03",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301057489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3479730-10",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mghali445356@direct.hfhs.org",
            "affiliation": "Y",
            "affiliationName": "Henry Ford Health System",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2799 W Grand Blvd",
            "city": "Detroit",
            "state": "MI",
            "country_code": "US",
            "postal_code": "482022608",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mghali24324@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sylvania, OH

Sources for this page

Verify at the official NPI Registry.