Individual provider Active NPI

Kamal Mohamed-Ayed Kassem, MD

  • Cardiovascular Disease Physician
  • Dearborn, MI
National Provider Identifier
1073049516
Registry record updated Oct 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
4301509574 Issued in MI
Practice address
15120 Michigan Ave Ste B
Dearborn, MI 48126-3768
Phone
(313) 436-0733
Fax
(313) 436-0735
NPI assigned
May 3, 2017
Last updated
Oct 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 53759 KY
Cardiovascular Disease Physician 207RC0000X 4301509574 MI Primary
Interventional Cardiology Physician 207RI0011X 4301509574 MI

Addresses

Primary practice location

15120 Michigan Ave Ste B
Dearborn, MI 48126-3768

Mailing address

15120 Michigan Ave Ste B
Dearborn, MI 48126-3768
Phone (313) 436-0733

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240614003486 MI Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 3375812456 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Northern MichiganGroup PAC ID 9931018181, 60 clinicians
Cardiology Institute of Michigan PLLCGroup PAC ID 3173510112, 11 clinicians

Practice addresses (Care Compare)

15120 Michigan Ave
Suite a
Dearborn, MI 48126-3768
Phone (313) 436-0733

416 Connable Ave
Petoskey, MI 49770-2212
Phone (231) 487-4000

5100 Gateway Ctr
Flint, MI 48507-3927
Phone (810) 733-0790

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting60
Pacemaker insertion or repair1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53759KYMDInternal Medicine Physician
4301509574MIMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dearborn Heart & Vascular Associates PLLC Cardiovascular Disease CurrentSince Mar 1, 2026 Accepting new patients
Cardiology Institute of Michigan, PLLC Cardiovascular Disease CurrentSince Jun 1, 2024 Accepting new patients

Locations

15120 Michigan Ave
Ste B
Dearborn, MI 48126
Phone (313) 253-0600

5100 Gateway Ctr
Flint, MI 48507
Phone (810) 733-0790

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EFCBED/Endpoint/EFCBED

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791244800000",
    "number": "1073049516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15120 MICHIGAN AVE STE B",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263768",
            "telephone_number": "313-436-0733",
            "fax_number": "313-436-0735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15120 MICHIGAN AVE STE B",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263768",
            "telephone_number": "313-436-0733",
            "fax_number": "313-436-0735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSEM",
        "first_name": "KAMAL",
        "middle_name": "MOHAMED-AYED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-03",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "53759",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "4301509574",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MI",
            "license": "4301509574",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.