Individual provider Active NPI

Ahmad Khayat, MD

  • Pulmonary Disease Physician
  • Marinette, WI
National Provider Identifier
1619084142
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
42686-20 Issued in WI
Practice address
3003 University Dr
Marinette, WI 54143-4110
Phone
(715) 735-4690
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 4301071052 MI
Pulmonary Disease Physician 207RP1001X 42686-20 WI Primary

Addresses

Primary practice location

3003 University Dr
Marinette, WI 54143-4110

Mailing address

PO Box 735044
Chicago, IL 60673-5044

Other identifiers 1

IdentifierTypeStateIssuer
34073600MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address akhayat56081@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20100126000527 WI Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 3274675426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

3003 University Dr
Marinette, WI 54143-4110
Phone (715) 735-6621

Hospital & facility affiliations

  • Aurora Medical Center Bay Area Hospital, Marinette, WI, CCN 520113
  • Aurora Baycare Medical Ctr Hospital, Green Bay, WI, CCN 520193

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301071052MIMDPulmonary Disease Physician
42686-20WIMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Jul 1, 2001 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jul 1, 2001 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

N306 Maple St
Stephenson, MI 49887
Phone (906) 753-2231

2733 S Ridge Rd
Green Bay, WI 54304
Phone (920) 497-6200

3003 University Dr
Ste 201
Marinette, WI 54143

3003 University Dr
Marinette, WI 54143
Phone (715) 735-4200

3130 Shore Dr
Marinette, WI 54143
Phone (715) 735-7421

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

Interoperability endpoints

  • Direct secure messaging: akhayat56081@direct.myadvocateaurora.org

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 4

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1619084142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 UNIVERSITY DR",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434110",
            "telephone_number": "715-735-4690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAYAT",
        "first_name": "AHMAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MI",
            "license": "4301071052",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WI",
            "license": "42686-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34073600",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akhayat56081@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3130 Shore Dr",
            "city": "Marinette",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541434291",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3130 Shore Dr",
            "city": "Marinette",
            "state": "WI",
            "country_code": "US",
            "postal_code": "541434291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marinette, WI

Sources for this page

Verify at the official NPI Registry.