Individual provider Active NPI

Michael Khalil, M.D.

  • Emergency Medicine Physician
  • Detroit, MI
National Provider Identifier
1477816346
Registry record updated Sep 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301101244 Issued in MI
Practice address
4201 St Antoine Ste 3R
Detroit, MI 48201-1446
Phone
(313) 420-8630
NPI assigned
Jun 16, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301101244 MI Primary

Addresses

Primary practice location

4201 St Antoine Ste 3R
Detroit, MI 48201-1446

Mailing address

4201 St Antoine
Ste 3R
Detroit, MI 48201

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
I20160706001421 MI Practitioner - Emergency Medicine 7113247321 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Center Emergency ServicesGroup PAC ID 0648182071, 30 clinicians

Practice addresses (Care Compare)

6071 W Outer Dr
Detroit, MI 48235-2624
Phone (313) 966-3300

Hospital & facility affiliations

  • Harper University Hospital Hospital, Detroit, MI, CCN 230104
  • Sinai-Grace Hospital Hospital, Detroit, MI, CCN 230024

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301101244MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Center Emergency Services CurrentSince Jul 1, 2016 Accepting new patients

Locations

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

6071 W Outer Dr
Detroit, MI 48235
Phone (313) 966-3300

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1339804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504569600000",
    "number": "1477816346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 ST ANTOINE",
            "address_2": "STE 3R",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 ST ANTOINE STE 3R",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482011446",
            "telephone_number": "313-420-8630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIL",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-16",
        "last_updated": "2017-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301101244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.