Individual provider Active NPI

Ziyadeh Michael Khoury, D.O.

  • Anesthesiology Physician
  • Flint, MI
National Provider Identifier
1578618674
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
5101010658 Issued in MI
Practice address
1051 Professional Dr
Flint, MI 48532-3636
Phone
(810) 720-1730
Fax
(810) 720-1736
NPI assigned
Jan 25, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 5101010658 MI Primary

Addresses

Primary practice location

1051 Professional Dr
Flint, MI 48532-3636

Mailing address

1051 Professional Dr
Flint, MI 48532-3636
Phone (810) 720-1730

Other identifiers 1

IdentifierTypeStateIssuer
2942887MedicaidMI

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
I20050920000343 MI Practitioner - Anesthesiology 0345228250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Services Associates PCGroup PAC ID 4385557602, 67 clinicians

Practice addresses (Care Compare)

1221 Pine Grove Ave
Port Huron, MI 48060-3511
Phone (810) 987-5000

1221 Pine GRV
Port Huron, MI 48060-3511

2775 Blake Rd
Jackson, MI 49201-8838
Phone (517) 787-2906

401 S Ballenger Hwy
Flint, MI 48532-3638
Phone (810) 342-2000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Services Associates, PC Anesthesiology CurrentSince Jan 12, 2015 Accepting new patients
Michigan Medical Anesthesia, .P,C, Anesthesiology PastSince Jan 1, 1981 Accepting new patients

Locations

501 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-4800

2775 Blake Rd
Jackson, MI 49201
Phone (517) 787-2906

432 W University Dr
Rochester, MI 48307
Phone (248) 651-6122

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

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": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578618674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 PROFESSIONAL DR",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323636",
            "telephone_number": "810-720-1730",
            "fax_number": "810-720-1736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 PROFESSIONAL DR",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323636",
            "telephone_number": "810-720-1730",
            "fax_number": "810-720-1736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOURY",
        "first_name": "ZIYADEH",
        "middle_name": "MICHAEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MI",
            "license": "5101010658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2942887",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.