Reda A Khalifa, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

RK072714 Issued in MI

Practice address

3675 Highland Rd
Suite 112
Waterford, MI 48328-2326

Phone

(248) 683-8050

Fax

(248) 683-8590

NPI assigned

Jun 12, 2006

Last updated

Apr 26, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MI, CO, IA3 enrollments

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 3

Specialty

Obstetrics/Gynecology

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial Medical Center of West MichiganGroup PAC ID 3678543659, 62 clinicians

Waverly Health CenterGroup PAC ID 8820996762, shared by 10 NPIs, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Luis Valley Regional Medical Center Hospital, Alamosa, CO, CCN 060008

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Memorial Medical Center of West Michigan

  dba Corewell Health Ludington Hospital

  • General Acute Care Hospital
  • Ludington, MI
  • NPI 1972589489
  Medicare reassignment Care Compare group NPD
• Lutheran Hospital Association of the San Luis Valley

  dba San Luis Valley Health Regional Medical Center

  • General Acute Care Hospital
  • Alamosa, CO
  • NPI 1235181744
  Medicare reassignment NPD
• Waverly Health Center

  • Critical Access Hospital
  • Waverly, IA
  • NPI 1447299953
  Medicare reassignment
• Waverly Health Center

  • Family Medicine Physician
  • Waverly, IA
  • NPI 1598959371
  Medicare reassignment
• Dr Khalifa Reda PLLC

  • Obstetrics & Gynecology Physician
  • Waterford, MI
  • NPI 1578678140
  Authorized official Same address or phone
• Memorial Medical Center of West Michigan

  dba Corewell Health Ludington Hospital Professional

  • Family Medicine Physician
  • Ludington, MI
  • NPI 1144639360
  NPD
• Lutheran Hospital Association of the San Luis Valley

  dba SLV Health Conejos County Hospital

  • Critical Access Hospital Clinic/Center
  • La Jara, CO
  • NPI 1194792762
  NPD
• St Joseph Mercy Hospital-SMHC

  dba St Joseph Mercy Oakland

  • General Acute Care Hospital
  • Pontiac, MI
  • NPI 1053356352
  NPD (past)
• Lutheran Hospital Association of the San Luis Valley

  dba SLV Health La Jara Clinic

  • Rural Health Clinic/Center
  • La Jara, CO
  • NPI 1942511019
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lutheran Hospital Association of the San Luis Valley

  dba San Luis Valley Health Regional Medical Center

  • General Acute Care Hospital
  • Alamosa, CO
  • NPI 1235181744
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1396787586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1268 LAKE CRESCENT DR",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483022814",
            "telephone_number": "248-683-8050",
            "fax_number": "248-683-8590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3675 HIGHLAND RD",
            "address_2": "SUITE 112",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282326",
            "telephone_number": "248-683-8050",
            "fax_number": "248-683-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIFA",
        "first_name": "REDA",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "RK072714",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0F32730",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "RK072714",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4757476",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Leeland Kerre, D.D.S.
• Ketner Orthopedics PLLC
• Andrew John Ketner, D.O.
• John Marshall Ketner, D.O.
• Keystone Home Care
• Devyani S Khambete, M.D.
• Sana Khan
• Shazia Khan, OTRL
• Kiddie Kingdum Academy
• Christine Kilbride

• Obstetrics & Gynecology Physician in Waterford, MI
• Providers in Waterford, MI by specialty
• Obstetrics & Gynecology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.