Individual provider Active NPI

Ammar Ghanem, MD

  • Pulmonary Disease Physician
  • Rochester Hills, MI
National Provider Identifier
1528026424
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
4301111042 Issued in MI
Practice address
75 Barclay Cir Ste 205
Rochester Hills, MI 48307-5821
Phone
(260) 416-5892
Fax
(260) 416-5897
NPI assigned
May 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35085090 OH
Pulmonary Disease Physician 207RP1001X 01067395 IN
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 35085090 OH
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 01067395 IN
Pulmonary Disease Physician 207RP1001X 35085090 OH
Pulmonary Disease Physician 207RP1001X 4301111042 MI Primary
Sleep Medicine (Internal Medicine) Physician 207RS0012X 01067395 IN

Addresses

Primary practice location

75 Barclay Cir Ste 205
Rochester Hills, MI 48307-5821

Mailing address

75 Barclay Cir Ste 205
Rochester Hills, MI 48307-5821
Phone (248) 651-6430

Other identifiers 5

IdentifierTypeStateIssuer
000000658707OtherINANTHEM
200982500MedicaidIN
7424707OtherINAETNA
1346790896MedicaidMI
2626420MedicaidOH

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
I20161227001349 MI Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Sleep MedicinePractitioner - Internal Medicine 9537058193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine, Sleep Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1083 Suncrest Dr
Suite B
Lapeer, MI 48446-4421
Phone (810) 667-3111

75 Barclay Cir
Rochester Hills, MI 48307-5821
Phone (248) 651-6430

Hospital & facility affiliations

  • McLaren Lapeer Region Hospital, Lapeer, MI, CCN 230193
  • Ascension Providence Rochester Hospital Hospital, Rochester, MI, CCN 230254
  • McLaren Oakland Hospital, Pontiac, MI, CCN 230207
  • Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269
  • McLaren Flint Hospital, Flint, MI, CCN 230141

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35085090OHMDCritical Care Medicine (Internal Medicine) Physician
01067395INMDSleep Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ammar Ghanem MD PLLC Pulmonary Disease CurrentSince Nov 1, 2016 Accepting new patients
JMHC Inc Past Accepting new patients
Pulmonary Critical Care Inc Pulmonary Disease Past Accepting new patients

Locations

1540 Lake Lansing Rd
Ste 205
Lansing, MI 48912
Phone (517) 253-3910

401 W Greenlawn Ave
Lansing, MI 48910
Phone (517) 334-2286

1083 Suncrest Dr
Ste B
Lapeer, MI 48446
Phone (810) 245-5390

75 Barclay Cir
Ste 205
Rochester Hills, MI 48307
Phone (248) 651-6430

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.

Hospital & facility affiliations 5

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": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1528026424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 BARCLAY CIR STE 205",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483075821",
            "telephone_number": "248-651-6430",
            "fax_number": "260-416-5897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 BARCLAY CIR STE 205",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483075821",
            "telephone_number": "260-416-5892",
            "fax_number": "260-416-5897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHANEM",
        "first_name": "AMMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35085090",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "01067395",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OH",
            "license": "35085090",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IN",
            "license": "01067395",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OH",
            "license": "35085090",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "4301111042",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "IN",
            "license": "01067395",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000658707",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200982500",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7424707",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346790896",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2626420",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester Hills, MI

Sources for this page

Verify at the official NPI Registry.