Individual provider Active NPI

Fayyaz Mahmood, MD

  • Neurology Physician
  • Kalamazoo, MI
National Provider Identifier
1396709523
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
4301081100 Issued in MI
Practice address
1541 Gull Rd
Suite 100
Kalamazoo, MI 49048-1639
Phone
(269) 381-7380
Fax
(269) 341-4562
NPI assigned
Apr 14, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 4301081100 MI Primary

Addresses

Primary practice location

1541 Gull Rd
Suite 100
Kalamazoo, MI 49048-1639

Mailing address

1541 Gull Rd
Suite 100
Kalamazoo, MI 49048-1639
Phone (269) 381-7380

Other identifiers 2

IdentifierTypeStateIssuer
4733779MedicaidMI
4499872MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040401000062 MI Practitioner - Neurology 7517959364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascension Medical Group PromedGroup PAC ID 7315856077, 255 clinicians

Practice addresses (Care Compare)

1521 Gull Rd
Kalamazoo, MI 49048-1640
Phone (269) 226-5165

1541 Gull Rd
Suite 100
Kalamazoo, MI 49048-1645
Phone (269) 226-5290

215 E Mansion St
1H Borgess Neurology
Marshall, MI 49068-1167
Phone (269) 789-8120

3035 Capital Ave SW
Battle Creek, MI 49015-4334

711 S Health Pkwy
Three Rivers, MI 49093-9387

7901 Angling Rd
Portage, MI 49024-0714

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Promed Healthcare CurrentSince Feb 1, 2009 Accepting new patients
Beacon Medical Group Michigan Inc Current Accepting new patients
Beacon Medical Group Michigan Inc CurrentSince Feb 1, 2009 Accepting new patients

Locations

570 Linn St
Allegan, MI 49010
Phone (269) 686-4275

1541 Gull Rd
Ste 100
Kalamazoo, MI 49048
Phone (269) 226-5290

1717 Shaffer St
Ste 229
Kalamazoo, MI 49048
Phone (269) 381-0764

3025 Gull Rd
Kalamazoo, MI 49048
Phone (269) 343-1264

215 E Mansion St
Marshall, MI 49068
Phone (269) 789-8120

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1396709523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 GULL RD",
            "address_2": "SUITE 100",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481639",
            "telephone_number": "269-381-7380",
            "fax_number": "269-341-4562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 GULL RD",
            "address_2": "SUITE 100",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481639",
            "telephone_number": "269-381-7380",
            "fax_number": "269-341-4562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMOOD",
        "first_name": "FAYYAZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301081100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4733779",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4499872",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.