Individual provider Active NPI

Khaled Mahlies, M.D.

  • Internal Medicine Physician
  • Bedford, OH
National Provider Identifier
1497720585
Registry record updated Jul 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35071455 Issued in OH
Practice address
6 Columbus St
Bedford, OH 44146-2819
Phone
(440) 232-6467
Fax
(440) 786-9664
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35071455 OH Primary

Addresses

Primary practice location

6 Columbus St
Bedford, OH 44146-2819

Mailing address

6 Columbus St
Bedford, OH 44146-2819
Phone (440) 232-6467

Other identifiers 1

IdentifierTypeStateIssuer
2065652MedicaidOH

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
I20101018001327 OH Practitioner - Internal Medicine 6204029622

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6 Columbus St
Bedford, OH 44146-2819

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35071455OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Maple Heights Operating Co., LLC Past Accepting new patients
Cleveland Clinic Health System - East Region Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kmahlies37074@ehrdirect.uhhospitals.org

Organizations & group practices 2

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309478400000",
    "number": "1497720585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 COLUMBUS ST",
            "city": "BEDFORD",
            "state": "OH",
            "postal_code": "441462819",
            "telephone_number": "440-232-6467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 COLUMBUS ST",
            "city": "BEDFORD",
            "state": "OH",
            "postal_code": "441462819",
            "telephone_number": "440-232-6467",
            "fax_number": "440-786-9664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHLIES",
        "first_name": "KHALED",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2011-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35071455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2065652",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, OH

Sources for this page

Verify at the official NPI Registry.