NPIMap

Individual provider Active NPI

Ghadeer Noel Hannoudi, MD

  • Nephrology Physician
  • Pontiac, MI
National Provider Identifier
1124095948
Registry record updated Jan 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
4301075010 Issued in MI
Practice address
44200 Woodward Ave
Suite 209
Pontiac, MI 48341-5045
Phone
(248) 253-0330
Fax
(248) 253-1982
NPI assigned
Mar 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 4301075010 MI Primary

Addresses

Primary practice location

44200 Woodward Ave
Suite 209
Pontiac, MI 48341-5045

Mailing address

1886 W Auburn Rd
Suite 400
Rochester Hills, MI 48309-3865
Phone (248) 290-3111

Other identifiers 1

IdentifierTypeStateIssuer
4779722MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041029000218 MI Practitioner - NephrologyPractitioner - Internal Medicine 7315909710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Michigan Kidney Consultants PCGroup PAC ID 1052207115, 45 clinicians

Practice addresses (Care Compare)

1701 S Blvd E
Suite 320
Rochester Hills, MI 48307-6117
Phone (248) 290-3345

44200 Woodward Ave
Pontiac, MI 48341-5045

4600 Investment Dr
Suite 290
Troy, MI 48098-6374
Phone (248) 267-5010

Hospital & facility affiliations

  • DaVita Orchard Square Dialysis Dialysis facility, Bloomfield Hills, MI, CCN 232656
  • DaVita Bloomfield Hills Home Dialysis Dialysis facility, Bloomfield Hills, MI, CCN 232697
  • DaVita North Oakland Dialysis Dialysis facility, Pontiac, MI, CCN 232511
  • Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029
  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269
  • Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
  • Henry Ford Macomb Hospital Hospital, Clinton Township, MI, CCN 230047
  • Ascension Providence Rochester Hospital Hospital, Rochester, MI, CCN 230254

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301075010MIMDNephrology Physician

Interoperability endpoints

  • Direct secure messaging: ghannoudi1131312@direct.hfhs.org
  • Direct secure messaging: ghannoudi19008@direct.acumenmd.com
  • Direct secure messaging: ghannoudi36150@direct.trinity-health.org

Organizations & group practices 1

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 9

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": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263340800000",
    "number": "1124095948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1886 W AUBURN RD",
            "address_2": "SUITE 400",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483093865",
            "telephone_number": "248-290-3111",
            "fax_number": "248-290-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44200 WOODWARD AVE",
            "address_2": "SUITE 209",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483415045",
            "telephone_number": "248-253-0330",
            "fax_number": "248-253-1982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNOUDI",
        "first_name": "GHADEER",
        "middle_name": "NOEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2010-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301075010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4779722",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

Verify at the official NPI Registry.