Organization Active NPI

Family Practice Care PLLC

  • General Practice Physician
  • Roseville, MI
National Provider Identifier
1306959374
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
FAMILY PRACTICE CARE PLLC
Practice address
25350 Kelly Rd
Roseville, MI 48066-4961
Phone
(586) 773-8770
Fax
(586) 773-0133
NPI assigned
Aug 16, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mohamed Aslam Khan, M.D.
Title
Owner
Phone
(586) 773-8770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X MI Primary

Addresses

Primary practice location

25350 Kelly Rd
Roseville, MI 48066-4961

Mailing address

25350 Kelly Rd
Roseville, MI 48066-4961
Phone (586) 773-8770

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040510001554 MI Part B Supplier - Clinic/Group Practice 3476542812 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Warren, MI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

725 S Adams Rd
Ste 185
Birmingham, MI 48009
Phone (586) 393-6500

24424 Gratiot Ave
Eastpointe, MI 48021
Phone (586) 778-7575

22601 Harper Ave
Ste 1001
St Clr Shores, MI 48080
Phone (286) 778-8720

Practitioners & affiliated clinicians

Practitioners 11

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": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306959374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25350 KELLY RD",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664961",
            "telephone_number": "586-773-8770",
            "fax_number": "586-773-0133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25350 KELLY RD",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664961",
            "telephone_number": "586-773-8770",
            "fax_number": "586-773-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_middle_name": "ASLAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-773-8770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.