Individual provider Active NPI

Abed Kanzy Abbas Kanzy, M.D

  • Hospitalist Physician
  • Flint, MI
National Provider Identifier
1265729370
Registry record updated Jun 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
35.133176 Issued in OH
Practice address
2700 Robert T Longway Blvd Ste B
Flint, MI 48503-2190
Phone
(810) 399-9641
NPI assigned
Jul 9, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301098729 MI
Hospitalist Physician 208M00000X 35.133176 OH Primary

Addresses

Primary practice location

2700 Robert T Longway Blvd Ste B
Flint, MI 48503-2190

Mailing address

2700 Robert T Longway Blvd Ste B
Flint, MI 48503-2190
Phone (810) 399-9641

Other practice location 1

3000 Arlington Ave
Toledo, OH 43614-2595
Phone (419) 383-3811

Other identifiers 1

IdentifierTypeStateIssuer
0382200MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301098729MIMDInternal Medicine Physician
35.133176OHMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical University of Ohio at Toledo Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

3000 Arlington Ave
Toledo, OH 43614
Phone (419) 383-3556

Interoperability endpoints

  • Direct secure messaging: akanzy4016@direct.hurleymc.com
  • Direct secure messaging: akanzy24320@direct.utoledo.edu

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1310169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1265729370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 ROBERT T LONGWAY BLVD STE B",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032190",
            "telephone_number": "810-399-9641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 ROBERT T LONGWAY BLVD STE B",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032190",
            "telephone_number": "810-399-9641"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 Arlington Ave",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436142595",
            "country_code": "US",
            "telephone_number": "419-383-3811",
            "fax_number": "419-383-2918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANZY",
        "first_name": "ABED",
        "middle_name": "KANZY ABBAS",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-09",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301098729",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35.133176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0382200",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.