Individual provider Active NPI

Mohamed M Khalifa, M.D.

  • Clinical Genetics (M.D.) Physician
  • Akron, OH
National Provider Identifier
1407077621
Registry record updated Sep 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X
License
35-088981 Issued in OH
Practice address
1 Perkins SQ
Akron, OH 44308-1063
Phone
(330) 543-8792
Fax
(330) 543-3677
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Genetics (M.D.) Physician 207SG0201X 35-088981 OH Primary
Clinical Biochemical Genetics Physician 207SG0202X 35-088981 OH
Clinical Molecular Genetics Physician 207SG0203X 35-088981 OH

Addresses

Primary practice location

1 Perkins SQ
Akron, OH 44308-1063

Mailing address

1 Perkins SQ
Akron, OH 44308-1063
Phone (330) 543-8792

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20080130000055 OH Practitioner - Pediatric MedicinePractitioner - Medical Genetics and Genomics 9739106030 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-088981OHMDClinical Molecular Genetics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Medical Center of Akron Current Accepting new patients
Children'S Hospital Medical Center of Akron CurrentSince Apr 23, 2007 Accepting new patients
Children'S Hospital Medical Center of Akron CurrentSince Apr 23, 2007 Accepting new patients

Locations

1 Perkins Sq
Akron, OH 44308
Phone (330) 543-8050

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378252800000",
    "number": "1407077621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PERKINS SQ",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081063",
            "telephone_number": "330-543-8792",
            "fax_number": "330-543-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PERKINS SQ",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081063",
            "telephone_number": "330-543-8792",
            "fax_number": "330-543-3677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIFA",
        "first_name": "MOHAMED",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2013-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "OH",
            "license": "35-088981",
            "primary": true
        },
        {
            "code": "207SG0202X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Biochemical Genetics",
            "state": "OH",
            "license": "35-088981",
            "primary": false
        },
        {
            "code": "207SG0203X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Molecular Genetics",
            "state": "OH",
            "license": "35-088981",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.