Individual provider Active NPI

Khashayar Ahmadmehrabi

  • Rheumatology Physician
  • Ann Arbor, MI
National Provider Identifier
1083174577
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
4301512155 Issued in MI
Practice address
4350 Jackson Rd Ste 320
Ann Arbor, MI 48103-1890
Phone
(734) 426-1931
Fax
(734) 426-9021
NPI assigned
Mar 21, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X 4301512155 MI Primary

Addresses

Primary practice location

4350 Jackson Rd Ste 320
Ann Arbor, MI 48103-1890

Mailing address

24 Frank Lloyd Wright Dr Ste J2000
Ann Arbor, MI 48105-9484
Phone (734) 747-6766

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240717001580 MI Practitioner - RheumatologyPractitioner - Internal Medicine 4688901291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

128 Van Buren St
Chelsea, MI 48118-1623
Phone (734) 475-8677

14288 E Old US Hwy 12
Chelsea, MI 48118-2700

44428 Woodward Ave
Suite 102
Pontiac, MI 48341-5009
Phone (734) 712-8700

51341 W Huron River Dr
Trinity Health Iha Medical Group Primary Ca
Van Buren Township, MI 48111-2571
Phone (734) 997-0304

5301 E Huron River Dr
Ypsilanti, MI 48197-1051

5301 McAuley Dr
Ypsilanti, MI 48197-1051

Hospital & facility affiliations

  • Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156
  • Chelsea Hospital Hospital, Chelsea, MI, CCN 230259
  • Trinity Health Livingston Hospital Hospital, Howell, MI, CCN 230069
  • University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301512155MIMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center Current Accepting new patients
Iha Health Services Corporation Multi-Specialty CurrentSince Aug 1, 2024 Accepting new patients
Iha Health Service Corporation Multi-Specialty CurrentSince Aug 1, 2024 Accepting new patients
Iha Health Services Corporation Multi-Specialty Current Accepting new patients
Iha Health Services Corporation Multi-Specialty Past Accepting new patients

Locations

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

4350 Jackson Rd
Ste 320
Ann Arbor, MI 48103
Phone (734) 426-1931

14288 E Old US Highway 12
Ste 200
Chelsea, MI 48118
Phone (734) 475-8677

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

Interoperability endpoints

  • Direct secure messaging: kahmadmehrabi85370@direct.luhs.org
  • Direct secure messaging: kahmadmehrabi540543@direct.hfhs.org
  • Direct secure messaging: kahmadmehrabi3491429@direct.trinity-health.org

Organizations & group practices 5

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

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": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1083174577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR STE J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 JACKSON RD STE 320",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481031890",
            "telephone_number": "734-426-1931",
            "fax_number": "734-426-9021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMADMEHRABI",
        "first_name": "KHASHAYAR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-21",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "MI",
            "license": "4301512155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.