Individual provider Active NPI

Mounir Mikhaeil, MD

  • General Practice Physician
  • Troy, MI
National Provider Identifier
1134452501
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
4301095424 Issued in MI
Practice address
500 Kirts Blvd
Suite 200
Troy, MI 48084-4134
Phone
(248) 824-6060
Fax
(248) 686-0772
NPI assigned
Sep 16, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Physician 207U00000X 4301095424 MI
General Practice Physician 208D00000X 4301095424 MI Primary

Addresses

Primary practice location

500 Kirts Blvd
Suite 200
Troy, MI 48084-4134

Mailing address

PO Box 1239
Troy, MI 48099-1239
Phone (248) 824-6600

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
I20090930000512 MI Practitioner - Family PracticePractitioner - General PracticePractitioner - Nuclear Medicine 1153467410 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vpa PCGroup PAC ID 9234041948, 181 clinicians

Practice addresses (Care Compare)

Troy, MI 48084
Phone (248) 824-6060

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC Family Medicine CurrentSince Oct 12, 2009 Accepting new patients
Vpa PC Current Accepting new patients
Vpa PC Family Medicine Current Accepting new patients
Vpa PC Family Medicine CurrentSince Oct 12, 2009 Accepting new patients
Iah of Michigan, PLLC Family Medicine CurrentSince Sep 1, 2015 Accepting new patients

Locations

2205 Jolly Rd
Ste B
Okemos, MI 48864
Phone (517) 347-4085

500 Kirts Blvd
Ste 100
Troy, MI 48084
Phone (214) 824-6000

500 Kirts Blvd
Ste 200
Troy, MI 48084
Phone (248) 824-6060

Interoperability endpoints

  • Direct secure messaging: mounir.mikhaeil.1@32913.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1134452501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1239",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480991239",
            "telephone_number": "248-824-6600",
            "fax_number": "248-324-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 KIRTS BLVD",
            "address_2": "SUITE 200",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844134",
            "telephone_number": "248-824-6060",
            "fax_number": "248-686-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKHAEIL",
        "first_name": "MOUNIR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-16",
        "last_updated": "2021-03-04",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "MI",
            "license": "4301095424",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301095424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.