NPIMap

Individual provider Active NPI

Michael G. Khamis, M.D.

  • Diagnostic Radiology Physician
  • Richmond, IN
National Provider Identifier
1215994504
Registry record updated Apr 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
01041206 Issued in IN
Practice address
1100 Reid Pkwy
Richmond, IN 47374-1157
Phone
(765) 983-3164
NPI assigned
Apr 28, 2006
Last updated
Apr 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2022

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 01041206 IN Primary

Addresses

Primary practice location

1100 Reid Pkwy
Richmond, IN 47374-1157

Mailing address

1100 Reid Pkwy
Richmond, IN 47374-1157
Phone (765) 983-3164

Other identifiers 1

IdentifierTypeStateIssuer
200051030MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mkhamis305956@ReidHealth.direct-ci.com REID HOSPITAL & HEALTH CARE SERVICES, INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100619000004 IN Practitioner - Diagnostic Radiology 2163421124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Indiana University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reid Physician Associates IncGroup PAC ID 6406910769, 427 clinicians

Practice addresses (Care Compare)

1100 Reid Pkwy
Richmond, IN 47374-1157
Phone (765) 983-3122

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01041206INMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reid Physician Associates, Inc CurrentSince Mar 7, 2022 Accepting new patients
Reid Hospital & Health Care Services Inc Family Medicine Past Accepting new patients

Locations

1100 Reid Pkwy
Richmond, IN 47374
Phone (765) 983-3000

473 SE Greenville Ave
Winchester, IN 47394
Phone (765) 584-0004

Interoperability endpoints

  • Direct secure messaging: mkhamis305956@ecommunitydirect.com
  • Direct secure messaging: mkhamis305956@reidhealth.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1215994504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 REID PKWY",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741157",
            "telephone_number": "765-983-3164",
            "fax_number": "765-983-3260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 REID PKWY",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473741157",
            "telephone_number": "765-983-3164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAMIS",
        "first_name": "MICHAEL",
        "middle_name": "G.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01041206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200051030",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkhamis305956@ReidHealth.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "REID HOSPITAL & HEALTH CARE SERVICES, INC",
            "address_1": "1100 Reid Pkwy",
            "city": "Richmond",
            "state": "IN",
            "country_code": "US",
            "postal_code": "473741157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Richmond, IN

Sources for this page

Verify at the official NPI Registry.