Khaled Samir Hafez, MB, BCH

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

4301078224 Issued in MI

Practice address

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000

Phone

(734) 936-4000

NPI assigned

Sep 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Urology

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Regents of the University of MichiganGroup PAC ID 3779496856, 3,344 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046
• Mymichigan Medical Center Midland Hospital, Midland, MI, CCN 230222

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: khafez26626@direct.med.umich.edu

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.

• Regents of the University of Michigan

  • Urology Physician
  • Ann Arbor, MI
  • NPI 1437184884
  Medicare reassignment Care Compare group NPD
• Mymichigan Medical Center Midland

  • Multi-Specialty Clinic/Center
  • Midland, MI
  • NPI 1205889490
  Medicare reassignment NPD
• Mymichigan Medical Group

  • Multi-Specialty Clinic/Center
  • Midland, MI
  • NPI 1689623506

  Urology

  Medicare reassignment NPD
• Mymichigan Medical Center Alpena

  • Rural Health Clinic/Center
  • Alpena, MI
  • NPI 1144722604
  NPD
• Mymichigan Medical Center Midland

  • Anesthesiology Physician
  • Midland, MI
  • NPI 1649010455
  NPD
• Regents of the University of Michigan

  • Specialty Pharmacy
  • Dexter, MI
  • NPI 1952181919
  NPD
• Regents of the University of Michigan

  • General Acute Care Hospital
  • Ann Arbor, MI
  • NPI 1003878539
  NPD (past)

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

• Mymichigan Medical Center Midland

  • Multi-Specialty Clinic/Center
  • Midland, MI
  • NPI 1205889490

  Hospital

  Care Compare affiliation
• Mymichigan Medical Center Midland

  • General Acute Care Hospital
  • Midland, MI
  • NPI 1376973149
  Care Compare affiliation
• Mymichigan Medical Center Midland

  • General Acute Care Hospital
  • Midland, MI
  • NPI 1902841414
  Care Compare affiliation
• Regents of the University of Michigan

  • General Acute Care Hospital
  • Ann Arbor, MI
  • NPI 1003878539
  Care Compare affiliation

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583366400000",
    "number": "1144311564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095000",
            "telephone_number": "734-936-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAFEZ",
        "first_name": "KHALED",
        "middle_name": "SAMIR",
        "credential": "MB, BCH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MI",
            "license": "4301078224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4630539",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Hadrian
• Hope K Haefner, MD
• Jessica Haefner, MD
• Ashlie Lynn Haeussler, RN
• Evan Haezebrouck
• Jennifer Bourdeau Haft, OTR/L
• Jonathan William Haft, MD
• Hilary M Haftel, MD
• Kate Miller Hagadone, MA, PHD, LP
• Leah Pechin Hagamen, PT

• Urology Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Urology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.