Kim Ford Kezlarian, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301041887 Issued in MI

Practice address

26300 Woodward Ave
Royal Oak, MI 48067-0917

Phone

(245) 546-2110

Fax

(248) 546-8176

NPI assigned

Nov 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkezlarian12816@direct.hfhs.org

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.

• Henry Ford Health System

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1134144801
  Medicare reassignment NPD
• Henr Y Ford Health System

  • Family Medicine Physician
  • Detroit, MI
  • NPI 1952485351
  NPD
• Henry Ford Health System

  • Community/Retail Pharmacy
  • Plymouth, MI
  • NPI 1942931720
  NPD

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350259200000",
    "number": "1558440628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26300 WOODWARD AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480670917",
            "telephone_number": "245-546-2110",
            "fax_number": "248-546-8176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26300 WOODWARD AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480670917",
            "telephone_number": "245-546-2110",
            "fax_number": "248-546-8176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEZLARIAN",
        "first_name": "KIM",
        "middle_name": "FORD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2012-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301041887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0F32365",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104860996",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shereen Salem Keritum, MD
• Hugh Kerr
• Susan Lynn Kessler, MD
• Christopher W Keyes, MD
• Katherine Kezelian, LMSW
• Naushaba Ishrath Khalid, M.D.
• Khalil M. Karadsheh, M.D., P.C.
• Abdul-Majid Khan
• Adil Khan, M.D.
• Ali Khan

• Family Medicine Physician in Royal Oak, MI
• Providers in Royal Oak, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.