Individual provider Active NPI

Nasser Kassem Alkhalil, RPT

  • Physical Therapist
  • Dearborn, MI
National Provider Identifier
1275730608
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501006695 Issued in MI
Practice address
22725 Sheridan St
Dearborn, MI 48128-1832
Phone
(313) 406-5678
NPI assigned
Jun 29, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501006695 MI Primary

Addresses

Primary practice location

22725 Sheridan St
Dearborn, MI 48128-1832

Mailing address

22725 Sheridan St
Dearborn, MI 48128-1832
Phone (313) 406-5678

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070913000583 MI Practitioner - Physical Therapist in Private Practice 8426142076 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

20240 W 12 Mile Rd
Southfield, MI 48076-2426
Phone (248) 331-1400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5501006695MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Outcomes Management,LLC Physical Therapist CurrentSince Jul 8, 2024 Accepting new patients
Mercy Rehabilitation Corp CurrentSince Jul 1, 2007 Accepting new patients

Locations

20240 W 12 Mile Rd
Ste 1
Southfield, MI 48076
Phone (248) 331-1400

210 Town Center Dr
Troy, MI 48084
Phone (248) 643-8900

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": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275730608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22725 SHERIDAN ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281832",
            "telephone_number": "313-406-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22725 SHERIDAN ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281832",
            "telephone_number": "313-406-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALKHALIL",
        "first_name": "NASSER",
        "middle_name": "KASSEM",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501006695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.