NPIMap

Individual provider Active NPI

Khaled Adil, MD

  • Radiation Oncology Physician
  • Albany, NY
National Provider Identifier
1669944237
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
4301505747 Issued in MI
Practice address
43 New Scotland Ave
Albany, NY 12208-3412
Phone
(518) 262-3368
NPI assigned
Dec 20, 2018
Last updated
Dec 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 293471 NY
Radiation Oncology Physician 2085R0001X 4301505747 MI Primary

Addresses

Primary practice location

43 New Scotland Ave
Albany, NY 12208-3412

Mailing address

49 Sheridan Ave Apt 203
Albany, NY 12210-2705
Phone (514) 803-6553

Other practice location 1

2800 W Grand Blvd
Detroit, MI 48202-2610
Phone (800) 653-6568

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211203001272 MI Practitioner - Radiation Oncology 0648517896 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

1 Ford PL
Detroit, MI 48202-3450
Phone (313) 874-6677

15855 19 Mile Rd
Clinton Township, MI 48038-3504
Phone (586) 263-2300

19675 Allen Rd
Brownstown TWP, MI 48183-1021
Phone (734) 479-3311

205 N E Ave
Jackson, MI 49201-1753
Phone (517) 205-4800

2799 W Grand Blvd
Detroit, MI 48202-2608

6773 W Maple Rd
West Bloomfield, MI 48322-3013
Phone (248) 661-6100

6777 W Maple Rd
West Bloomfield, MI 48322-3013
Phone (248) 661-6470

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301505747MIMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System Current Accepting new patients
W.a. Foote Memorial Hospital Radiation Oncology CurrentSince Dec 1, 2021 Accepting new patients
W.a. Foote Memorial Hospital CurrentSince Dec 1, 2021 Accepting new patients
Henry Ford Health System CurrentSince Dec 1, 2021 Accepting new patients
W. a. Foote Memorial Hospital Current Accepting new patients
Henry Ford Pathology Current Accepting new patients
Henry Ford Health System CurrentSince Dec 1, 2021 Accepting new patients
W.a. Foote Memorial Hospital Past Accepting new patients
Henry Ford Maplegrove Center Past Accepting new patients
Albany Medical College Past Accepting new patients

Locations

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-4316

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

2800 W Grand Blvd
Detroit, MI 48202
Phone (313) 230-1078

1102 E Michigan Ave
Jackson, MI 49201
Phone (517) 205-7299

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

130 N Sherman St
Leslie, MI 49251
Phone (517) 205-2500

Interoperability endpoints

  • Direct secure messaging: kadil766705@direct.hfhs.org

Organizations & group practices 10

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 6

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": "1545264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1669944237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 SHERIDAN AVE APT 203",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122102705",
            "telephone_number": "514-803-6553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 NEW SCOTLAND AVE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083412",
            "telephone_number": "518-262-3368"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 W Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482022610",
            "country_code": "US",
            "telephone_number": "800-653-6568",
            "fax_number": "313-876-1305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADIL",
        "first_name": "KHALED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-20",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NY",
            "license": "293471",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MI",
            "license": "4301505747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.