Active NPI
Leila Khanji
- Family Nurse Practitioner
- Dearborn, MI
National Provider Identifier
1679319909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704371568
- Practice address
- 660 S Waverly St
Dearborn, MI 48124-1652 - Phone
- (313) 244-4449
- NPI assigned
- Jul 5, 2024
- Last updated
- Jul 5, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704371568 | MI | Primary |
Addresses
Primary practice location
660 S Waverly St
Dearborn, MI 48124-1652
Mailing address
660 S Waverly St
Dearborn, MI 48124-1652
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1678 S Merriman Rd
Westland, MI 48186-5355
99 Rochester Ave
East Atlantic Beach, NY 11561-1032
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704371568 | MI | MD | Family Nurse Practitioner |
Organizations & group practices 1
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.
-
- Urgent Care Clinic/Center
- Westland, MI
- NPI 1861189151
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720137600000",
"number": "1679319909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "660 S WAVERLY ST",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481241652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "660 S WAVERLY ST",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481241652",
"telephone_number": "313-244-4449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHANJI",
"first_name": "LEILA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-05",
"last_updated": "2024-07-05",
"certification_date": "2024-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704371568",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.