Individual provider Active NPI

Mohammed Ali Khaleel, DO

  • Internal Medicine Physician
  • Livonia, MI
National Provider Identifier
1598943474
Registry record updated Oct 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101017527 Issued in MI
Practice address
20002 Farmington Rd
Building E
Livonia, MI 48152-1408
Phone
(248) 310-8395
Fax
(248) 474-1548
NPI assigned
Feb 4, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 5101017527 MI Primary

Addresses

Primary practice location

20002 Farmington Rd
Building E
Livonia, MI 48152-1408

Mailing address

20002 Farmington Rd
Building E
Livonia, MI 48152-1408
Phone (248) 310-8395

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
I20140314001787 MI Practitioner - Internal Medicine 0749425932

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101017527MIMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380672000000",
    "number": "1598943474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20002 FARMINGTON RD",
            "address_2": "BUILDING E",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521408",
            "telephone_number": "248-310-8395",
            "fax_number": "248-474-1548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20002 FARMINGTON RD",
            "address_2": "BUILDING E",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521408",
            "telephone_number": "248-310-8395",
            "fax_number": "248-474-1548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALEEL",
        "first_name": "MOHAMMED",
        "middle_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-04",
        "last_updated": "2013-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101017527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.