Individual provider Active NPI

Khaled Hammoud, M.D.

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1174962187
Registry record updated Jan 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
267691 Issued in MA
Practice address
800 Washington St
Boston, MA 02111-1552
Phone
(617) 636-0067
NPI assigned
Jun 24, 2013
Last updated
Jan 31, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 267691 MA Primary

Addresses

Primary practice location

800 Washington St
Boston, MA 02111-1552

Mailing address

99 Brookline St Unit 3
Cambridge, MA 02139-4543

Other practice location 1

268 W Saginaw St
Unit 302
East Lansing, MI 48823-2601
Phone (810) 874-9436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, MI, IL, OH4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20180529002520 MA Practitioner - Diagnostic Radiology 1456582212 Reassigns benefits to 2 organizations
I20201117000293 MI Practitioner - Diagnostic Radiology 1456582212 Reassigns benefits to 10 organizations
I20210922001314 IL Practitioner - Diagnostic Radiology 1456582212 Reassigns benefits to 1 organization
I20250617004003 OH Practitioner - Diagnostic Radiology 1456582212 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Tufts University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prime Radiology Consultants P.C.Group PAC ID 7416485040, 52 clinicians
Henry Ford Medical Group GenesysGroup PAC ID 7214288281, 96 clinicians
Insight Chicago IncGroup PAC ID 2860894706, 140 clinicians
Jawad a Shah MD PCGroup PAC ID 5799779633, 89 clinicians

Practice addresses (Care Compare)

1 Genesys Pkwy
Grand Blanc, MI 48439-8065
Phone (833) 364-7790

1096 S Belsay Rd
Suite G
Burton, MI 48509-1948
Phone (810) 743-1611

2525 S Michigan Ave
Chicago, IL 60616-2315
Phone (708) 382-1498

4800 S Saginaw St
Suite 1800
Flint, MI 48507-2677
Phone 8107329333116

529 Misty Morning Dr
Flushing, MI 48433-2195
Phone (833) 364-7790

826 W King St
Owosso, MI 48867-2120
Phone (833) 364-7790

900 Cooper Ave
Saginaw, MI 48602-5182
Phone (833) 364-7790

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
267691MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Art of Radiology Imaging Associates, PLLC Diagnostic Radiology CurrentSince Mar 1, 2022 Accepting new patients
Henry Ford Medical Group Genesys CurrentSince Mar 1, 2022 Accepting new patients
Jawad a Shah MD PC CurrentSince Nov 13, 2020 Accepting new patients
Community Health Center of Branch County CurrentSince Dec 1, 2024 Accepting new patients
Insight Chicago, Inc. CurrentSince Jun 12, 2021 Accepting new patients
Pratt Radiology Associates, Inc Diagnostic Radiology CurrentSince Aug 1, 2019 Accepting new patients
Henry Ford Medical Group Genesys Diagnostic Radiology CurrentSince Mar 1, 2022 Accepting new patients
Community Health Center of Branch County Current Accepting new patients
Memorial Hospital CurrentSince Apr 1, 2024 Accepting new patients
Regio T Penna MD, PC Current Accepting new patients
Insight Foundation of Trumbull Diagnostic Radiology CurrentSince Apr 4, 2025 Accepting new patients
Community Health Center of Branch County Current Accepting new patients
CT Center of Flint, PLLC CurrentSince Jan 1, 2026 Accepting new patients
Henry Ford Medical Group Genesys Current Accepting new patients
Community Health Center of Branch County CurrentSince Dec 1, 2024 Accepting new patients
Memorial Hospital CurrentSince Apr 1, 2024 Accepting new patients
Prime Radiology Consultants P.C. Diagnostic Radiology Current Accepting new patients
Insight Foundation of Trumbull CurrentSince Apr 4, 2025 Accepting new patients
Basha Diagnostics P C Diagnostic Radiology CurrentSince Sep 1, 2022 Accepting new patients
Complete Health Systems Inc CurrentSince Mar 1, 2019 Accepting new patients
Prime Radiology Consultants P.C. Diagnostic Radiology CurrentSince Feb 1, 2019 Accepting new patients
TMC Radiology Cra LLC Diagnostic Radiology CurrentSince Oct 19, 2022 Accepting new patients
Insight Chicago, Inc. CurrentSince Jun 12, 2021 Accepting new patients
Jawad a Shah, MD PC Diagnostic Radiology CurrentSince Nov 13, 2020 Accepting new patients
Genesys Integrated Group Practice PC Past Accepting new patients
Great Lakes Teleradiology Ventures LLC PastSince Jan 1, 2026 Accepting new patients

Locations

2525 S Michigan Ave
Chicago, IL 60616
Phone (312) 355-1153

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

4154 W Vienna Rd
Clio, MI 48420
Phone (810) 686-3747

274 E Chicago St
Coldwater, MI 49036
Phone (517) 279-5400

1096 S Belsay Rd
Ste G
Flint, MI 48509
Phone (810) 743-1611

1165 S Linden Rd
#B
Flint, MI 48532
Phone (810) 600-6300

2184 S Ballenger Hwy
Flint, MI 48503
Phone (810) 232-5627

4800 S Saginaw St
Flint, MI 48507
Phone (810) 275-9108

4800 S Saginaw St
Ste 1650
Flint, MI 48507
Phone (810) 275-9688

4800 S Saginaw St
Ste 1800
Flint, MI 48507
Phone (810) 732-8336

4800 S Saginaw St
Ste 1805
Flint, MI 48507
Phone (810) 275-9108

4800 S Saginaw St
Ste 1815
Flint, MI 48507
Phone (810) 275-9152

10785 S Saginaw St
Ste D
Grand Blanc, MI 48439
Phone (810) 695-6337

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

3337 Britton Rd
Perry, MI 48872
Phone (517) 625-3004

30701 Woodward Ave
Ste Ll
Royal Oak, MI 48073
Phone (248) 288-1600

800 S Washington Ave
Saginaw, MI 48601
Phone (989) 776-8000

900 Cooper Ave
Saginaw, MI 48602
Phone (989) 583-6122

200 Hemlock St
Tawas City, MI 48763
Phone (989) 362-0153

1350 E Market St
Warren, OH 44483
Phone (330) 841-5969

Organizations & group practices 28

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

View all 28

Hospital & facility affiliations 5

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": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517356800000",
    "number": "1174962187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 BROOKLINE ST UNIT 3",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021394543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-0067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "268 W Saginaw St",
            "address_2": "Unit 302",
            "address_purpose": "LOCATION",
            "city": "East Lansing",
            "state": "MI",
            "postal_code": "488232601",
            "country_code": "US",
            "telephone_number": "810-874-9436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMMOUD",
        "first_name": "KHALED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-24",
        "last_updated": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "267691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.