Individual provider Active NPI

Michael M Khouli, MD

  • Emergency Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1598924565
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01072606A Issued in IN
Practice address
550 University Blvd
Indianapolis, IN 46202-5149
Phone
(317) 944-4705
Fax
(317) 948-0943
NPI assigned
Jun 5, 2008
Last updated
Apr 25, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 11014313A IN
Emergency Medicine Physician 207P00000X 01072606A IN Primary
Pediatrics Physician 208000000X 01072606A IN

Addresses

Primary practice location

550 University Blvd
Indianapolis, IN 46202-5149

Mailing address

950 N Meridian Street
Suite 500
Indianapolis, IN 46204-3908
Phone (317) 963-0860

Other identifiers 1

IdentifierTypeStateIssuer
201101030MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20130809000646 IN Practitioner - Emergency Medicine 2466692868 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Indiana University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

10580 N Meridian St
Carmel, IN 46290-1028
Phone (317) 583-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01072606AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC Emergency Medicine Current Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
Icem-Wishard LLC Emergency Medicine CurrentSince Jul 1, 2013 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
Indiana University Health Care Associates, Inc CurrentSince Jul 1, 2013 Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

5208 Reliable Pkwy
Chicago, IL 60686

5911 Reliable Pkwy
Chicago, IL 60686

1206 E National Ave
Brazil, IN 47834
Phone (812) 442-2480

10580 N Meridian St
Carmel, IN 46290
Phone (317) 338-2273

13861 Olio Rd
Fishers, IN 46037
Phone (317) 338-7136

801 N State St
Greenfield, IN 46140
Phone (317) 462-5544

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

550 University Blvd
Indianapolis, IN 46202
Phone (217) 274-5000

720 Eskenazi Ave
Indianapolis, IN 46202
Phone (317) 880-0000

950 N Meridian St
Ste 500
Indianapolis, IN 46204
Phone (317) 962-4941

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Organizations & group practices 6

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 1

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": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1598924565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 N MERIDIAN STREET",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462043908",
            "telephone_number": "317-963-0860",
            "fax_number": "317-962-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 UNIVERSITY BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025149",
            "telephone_number": "317-944-4705",
            "fax_number": "317-948-0943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOULI",
        "first_name": "MICHAEL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-05",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11014313A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01072606A",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01072606A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201101030",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.