Organization Active NPI

Khadhory Mercy PLLC

  • Internal Medicine Physician
  • Sterling Heights, MI
National Provider Identifier
1205163060
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301083271 Issued in MI
Legal business name
KHADHORY MERCY PLLC
Practice address
35200 Dequindre Rd Ste 600
Sterling Heights, MI 48310-4841
Phone
(586) 786-8800
Fax
(586) 722-7446
NPI assigned
Nov 14, 2009
Last updated
Mar 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Authorized official

Name
Ghazawan K KashatNPI 1326250754
Title
President
Phone
(586) 786-8800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301083271 MI Primary

Addresses

Primary practice location

35200 Dequindre Rd Ste 600
Sterling Heights, MI 48310-4841

Mailing address

35200 Dequindre Rd Ste 600
Sterling Heights, MI 48310-4841
Phone (586) 786-8800

Other practice location 1

35450 Dequindre Rd
Suite 103
Sterling Heights, MI 48310-4810
Phone (586) 795-2980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220504001989 MI Part B Supplier - Clinic/Group Practice 4486041787 Receives reassigned benefits from 3 practitioners
Practice locations: Sterling Heights, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2326017Khadhory Mercy PLLC35200 Dequindre Road Suite 600, Sterling Heights, MI 48310Certificate of waiverJun 24, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1258156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648512000000",
    "number": "1205163060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35200 DEQUINDRE RD STE 600",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483104841",
            "telephone_number": "586-786-8800",
            "fax_number": "586-722-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35200 DEQUINDRE RD STE 600",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483104841",
            "telephone_number": "586-786-8800",
            "fax_number": "586-722-7446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35450 Dequindre Rd",
            "address_2": "SUITE 103",
            "address_purpose": "LOCATION",
            "city": "Sterling Heights",
            "state": "MI",
            "postal_code": "483104810",
            "country_code": "US",
            "telephone_number": "586-795-2980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KHADHORY MERCY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-14",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A",
        "authorized_official_last_name": "KASHAT",
        "authorized_official_first_name": "GHAZAWAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-786-8800"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301083271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.