Individual provider Active NPI

Michael Khalil, DO

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Emerson, NJ
National Provider Identifier
1366062143
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
25MB12646600 Issued in NJ
Practice address
466 Old Hook Rd Ste 1
Emerson, NJ 07630-1368
Phone
(201) 967-8221
NPI assigned
Apr 21, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 25MB12646600 NJ Primary

Addresses

Primary practice location

466 Old Hook Rd Ste 1
Emerson, NJ 07630-1368

Mailing address

466 Old Hook Rd Ste 1
Emerson, NJ 07630-1368

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250616000555 NJ Practitioner - Physical Medicine and RehabilitationPractitioner - Sports Medicine 5991216178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Sports Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MPV New Jersey MD Services PCGroup PAC ID 5991097669, 146 clinicians

Practice addresses (Care Compare)

466 Old Hook Rd
Suite 1
Emerson, NJ 07630-1368
Phone (201) 967-8221

Hospital & facility affiliations

  • Hackensack Meridian Health Pascack Valley Medical Hospital, Westwood, NJ, CCN 310130
  • Englewood Hospital and Medical Center Hospital, Englewood, NJ, CCN 310045
  • Valley Hospital Hospital, Paramus, NJ, CCN 310012
  • Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MPV New Jersey MD Services PC CurrentSince Aug 1, 2025 Accepting new patients
MPV New Jersey MD Services PC CurrentSince Aug 1, 2025 Accepting new patients

Locations

466 Old Hook Rd
Ste 1
Emerson, NJ 07630
Phone (201) 261-0821

1 W Ridgewood Ave
Ste 301
Paramus, NJ 07652
Phone (201) 444-7666

Interoperability endpoints

  • Direct secure messaging: mkhalil1352312@ahs.direct-ci.com
  • Direct secure messaging: michael.khalil.1@14448.direct.athenahealth.com

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.

Hospital & facility affiliations 5

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": "1587427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1366062143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "466 OLD HOOK RD STE 1",
            "city": "EMERSON",
            "state": "NJ",
            "postal_code": "076301368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "466 OLD HOOK RD STE 1",
            "city": "EMERSON",
            "state": "NJ",
            "postal_code": "076301368",
            "telephone_number": "201-967-8221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIL",
        "first_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-21",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NJ",
            "license": "25MB12646600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emerson, NJ

Sources for this page

Verify at the official NPI Registry.