Active NPI
Nermien Moustafa Kandeel, MD
- Neurology Physician
- Grand Rapids, MI
National Provider Identifier
1366291064
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 4351052977
- Practice address
- 220 Cherry St SE
Grand Rapids, MI 49503 - Phone
- (616) 685-5050
- NPI assigned
- May 15, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 4351052977 | MI | Primary |
Addresses
Primary practice location
220 Cherry St SE
Grand Rapids, MI 49503
Mailing address
200 Jefferson Ave SE
Jefferson BLDG, Suite 305
Grand Rapids, MI 49503
Phone (616) 685-6774
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4351052977 | MI | MD | Neurology Physician |
Interoperability endpoints
- nkandeel188844@uihealth.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715731200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733097600000",
"number": "1366291064",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 JEFFERSON AVE SE",
"address_2": "JEFFERSON BLDG, SUITE 305",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49503",
"telephone_number": "616-685-6774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 CHERRY ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "49503",
"telephone_number": "616-685-5050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANDEEL",
"first_name": "NERMIEN",
"middle_name": "MOUSTAFA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-15",
"last_updated": "2024-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MI",
"license": "4351052977",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.