NPIMap

Individual provider Active NPI

Khaled Mostafa Ismail, M.D.

  • Nephrology Physician
  • Livonia, MI
National Provider Identifier
1467674895
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
4301077887 Issued in MI
Practice address
18302 Middlebelt Rd
Livonia, MI 48152-5007
Phone
(248) 478-1500
Fax
(248) 478-2798
NPI assigned
May 3, 2007
Last updated
Sep 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 4301077887 MI Primary

Addresses

Primary practice location

18302 Middlebelt Rd
Livonia, MI 48152-5007

Mailing address

18302 Middlebelt Rd
Livonia, MI 48152-5007
Phone (248) 478-1500

Other practice location 1

14061 E 13 Mile Rd Ste 3
Warren, MI 48088-5866
Phone (248) 478-1500

Other identifiers 3

IdentifierTypeStateIssuer
11738444OtherCAQH
1467674895MedicaidMI
10-5185211MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070703000557 MI Practitioner - Nephrology 6002916186 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Wayne State University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hypertension Nephrology Associates PCGroup PAC ID 3274506092, 13 clinicians

Practice addresses (Care Compare)

18302 Middlebelt Rd
Livonia, MI 48152-5007
Phone (248) 478-1500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hypertension Nephrology Associates PC Nephrology CurrentSince Jul 1, 2007 Accepting new patients
Sciometrix Inc CurrentSince Jan 15, 2023 Accepting new patients
Sciometrix LLC CurrentSince May 9, 2022 Accepting new patients

Locations

7633 E Jefferson Ave
Ste 180
Detroit, MI 48214
Phone (248) 478-1500

18302 Middlebelt Rd
Livonia, MI 48152
Phone (248) 478-1500

306 S Washington Ave
Ste 600
Royal Oak, MI 48067

15565 Northland Dr W
Ste 700
Southfield, MI 48075

14061 E 13 Mile Rd
Ste 3
Warren, MI 48088
Phone (248) 478-1500

Interoperability endpoints

  • Direct secure messaging: khaledismail.hypertensionnephrologyassociates@135190.advancedmd-direct.com
  • Direct secure messaging: kismail@direct.dmc.org
  • Direct secure messaging: kismail59250@direct.hfhs.org

Organizations & group practices 4

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1467674895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18302 MIDDLEBELT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481525007",
            "telephone_number": "248-478-1500",
            "fax_number": "248-478-2798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18302 MIDDLEBELT RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481525007",
            "telephone_number": "248-478-1500",
            "fax_number": "248-478-2798"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14061 E 13 Mile Rd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Warren",
            "state": "MI",
            "postal_code": "480885866",
            "country_code": "US",
            "telephone_number": "248-478-1500",
            "fax_number": "248-478-2798",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISMAIL",
        "first_name": "KHALED",
        "middle_name": "MOSTAFA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301077887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11738444",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467674895",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10-5185211",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.