Individual provider Active NPI

Suad Khalil, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • East Lansing, MI
National Provider Identifier
1164738043
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
4301096493 Issued in MI
Practice address
804 Service Rd Ste A217
East Lansing, MI 48824-7015
Phone
(517) 353-8122
Fax
(517) 432-3713
NPI assigned
Aug 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4301096493 MI
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 4301096493 MI Primary

Addresses

Primary practice location

804 Service Rd Ste A217
East Lansing, MI 48824-7015

Mailing address

804 Service Rd Ste A109B
East Lansing, MI 48824-7015
Phone (517) 353-8122

Other identifiers 1

IdentifierTypeStateIssuer
1164738043MedicaidMI

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
I20160325000209 MI Practitioner - NeurologyPractitioner - Pediatric Medicine 1052630241 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Msu Health Care Inc.Group PAC ID 8628404936, 201 clinicians

Practice addresses (Care Compare)

804 Service Rd
East Lansing, MI 48824-7015
Phone (517) 353-8122

Hospital & facility affiliations

  • McLaren Greater Lansing Hospital, Lansing, MI, CCN 230167

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301096493MIMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Msu Health Care Inc. CurrentSince Sep 1, 2022 Accepting new patients
Capital Area Pathologists, PC Current Accepting new patients
Michigan State University Current Accepting new patients
Edward W. Sparrow Hospital Association Pediatrics CurrentSince Apr 1, 2016 Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Apr 1, 2016 Accepting new patients
Michigan State University Current Accepting new patients
Msu Health Care Inc Current Accepting new patients
Msu Health Care Inc. Neurology With Special Qualifications in Child Neurology CurrentSince Sep 1, 2022 Accepting new patients
Edward W Sparrow Hospital Association Past Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients
Michigan State University Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

804 Service Rd
#A201
East Lansing, MI 48824
Phone (517) 884-2976

804 Service Rd
Ste A217
East Lansing, MI 48824
Phone (517) 353-8122

4660 S Hagadorn Rd
Ste 500
East Lansing, MI 48823
Phone (517) 432-6144

804 Service Rd
Rm A217
East Lansing, MI 48824
Phone (517) 353-8122

804 Service Rd
#A217
East Lansing, MI 48824
Phone (517) 353-8122

804 Service Rd
Ste A109B
East Lansing, MI 48824
Phone (517) 884-2976

1200 E Michigan Ave
Ste 460
Lansing, MI 48912
Phone (517) 364-2097

401 W Greenlawn Ave
Lansing, MI 48910
Phone (517) 334-2286

Interoperability endpoints

  • Direct secure messaging: skhalil3678@sparrowdirecthie.org
  • Direct secure messaging: suad.khalil.1@25394.direct.athenahealth.com

Organizations & group practices 11

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 1

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": "1283126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1164738043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD STE A109B",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-353-8122",
            "fax_number": "517-432-3713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD STE A217",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-353-8122",
            "fax_number": "517-432-3713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIL",
        "first_name": "SUAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-30",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301096493",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "MI",
            "license": "4301096493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164738043",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

Verify at the official NPI Registry.