Khalid Mohammed Abulaban, M.D.

Primary specialty

Pediatric Rheumatology PhysicianTaxonomy code 2080P0216X

License

4301106734 Issued in MI

Practice address

35 Michigan St NE
Suite 4150
Grand Rapids, MI 49503-2514

Phone

(616) 267-2700

Fax

(616) 267-2701

NPI assigned

Jun 10, 2008

Last updated

Feb 19, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MI

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kabulaban110187@epic00.corewelldirect.org
• Direct secure messaging: kabulaban110187@epic00.shdirect.org

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.

• Beaumont Medical Group- Specialty Services

  • Surgery Physician
  • Royal Oak, MI
  • NPI 1578072906
  Medicare reassignment NPD
• Spectrum Health Hospitals

  dba Corewell Health Grand Rapids Hospitals

  • Hospitalist Physician
  • Grand Rapids, MI
  • NPI 1558407189
  Medicare reassignment NPD
• Spectrum Health Primary Care Partners

  dba Corewell Health Medical Group West

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1235188673
  Medicare reassignment NPD
• Western Michigan University School of Medicine

  dba WMed Health

  • Multi-Specialty Clinic/Center
  • Kalamazoo, MI
  • NPI 1316212343
  Medicare reassignment NPD
• Spectrum Health Hospitals

  dba Corewell Health Grand Rapids Hospital

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  NPD
• Spectrum Health Primary Care Partners

  dba Corewell Health Medical Group West

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1689499667
  NPD
• Michigan State University Kalamazoo Center for Medical Studies

  dba Msu/KCMS

  • Multi-Specialty Clinic/Center
  • Kalamazoo, MI
  • NPI 1568467249
  NPD (past)

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1033379458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 MICHIGAN ST NE",
            "address_2": "SUITE 4150",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032514",
            "telephone_number": "616-267-2700",
            "fax_number": "616-267-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABULABAN",
        "first_name": "KHALID",
        "middle_name": "MOHAMMED",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-10",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301106734",
            "primary": false
        },
        {
            "code": "2080P0216X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Rheumatology",
            "state": "MI",
            "license": "4301106734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kabulaban110187@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "35 Michigan St NE",
            "address_2": "Suite 4150",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032514",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "35 Michigan St NE",
            "address_2": "Suite 4150",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495032514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ebone Abrams, LLBSW
• Gabriella Abreo, MD
• Loanna Abreu Perez, MA, LLP
• Maria Katrina Abril, M.D.
• Farah Abu Dhais, MD
• Abundant Love Homecare LLC
• Camille Joy Reynante Abutin, MD
• Dominic Ondieki Abuya, FNP-BC
• Abyride LLC
• Academic Surgical Associates, PLLC

• Pediatric Rheumatology Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Pediatric Rheumatology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.