NPIMap

Individual provider Active NPI

Jamal Abu-Khaled, M.D.

  • Nephrology Physician
  • Royal Oak, MI
National Provider Identifier
1518285451
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
4301097734 Issued in MI
Practice address
3535 W 13 Mile Rd Ste 247
Royal Oak, MI 48073-6770
Phone
(248) 288-9340
Fax
(248) 551-6020
NPI assigned
May 16, 2010
Last updated
Jun 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 57.014265 OH
Nephrology Physician 207RN0300X 4301097734 MI Primary
Hospitalist Physician 208M00000X 4301097734 MI

Addresses

Primary practice location

3535 W 13 Mile Rd Ste 247
Royal Oak, MI 48073-6770

Mailing address

1886 W Auburn Rd Ste 400
Rochester Hills, MI 48309-3865
Phone (248) 290-3111

Other practice location 1

1886 W Auburn Rd Ste 400
Rochester Hills, MI 48309-3865
Phone (248) 290-3111 ext. 1713

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
I20110603000073 MI Practitioner - NephrologyPractitioner - Internal MedicinePractitioner - Hospitalist 9830376615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Kidney Consultants PCGroup PAC ID 1052207115, 45 clinicians

Practice addresses (Care Compare)

3475 Starr Rd
Royal Oak, MI 48073-2100
Phone (248) 290-3111

4600 Investment Dr
Suite 290
Troy, MI 48098-6374
Phone (248) 267-5010

5280 Metropolitan Pkwy
Sterling Heights, MI 48310-4005

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57.014265OHMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: jabukhaled18983@direct.acumenmd.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1273968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1518285451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1886 W AUBURN RD STE 400",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483093865",
            "telephone_number": "248-290-3111",
            "fax_number": "248-290-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 W 13 MILE RD STE 247",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480736770",
            "telephone_number": "248-288-9340",
            "fax_number": "248-551-6020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1886 W Auburn Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Rochester Hills",
            "state": "MI",
            "postal_code": "483093865",
            "country_code": "US",
            "telephone_number": "248-290-3111 x1713",
            "fax_number": "248-290-3100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ABU-KHALED",
        "first_name": "JAMAL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-05-16",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "57.014265",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "4301097734",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MI",
            "license": "4301097734",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

Verify at the official NPI Registry.