Affiliated Knee Pain Specialists, PLLC
Organization Active NPI Internal Medicine Physician · Beverly Hills, MI
NPI 1699262006 · NPPES record last updated Jan 24, 2023
Key facts
- NPI
- 1699262006
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 4301070138 (MI)
- Legal business name
- AFFILIATED KNEE PAIN SPECIALISTS, PLLC
- Practice address
- 31333 Southfield Rd Ste 103
Beverly Hills, MI 48025-5473 - Phone
- (248) 952-9190
- Fax
- (248) 952-9190
- NPI assigned
- Apr 20, 2018
- Organization subpart
- No
Authorized official
- Name
- Steve Z. Kallabat, MD
- Title
- Owner/Medical Doctor
- Phone
- (928) 445-7085
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Practitioners 9
-
Ashley Hindo, FNP-C
-
Steve Z Kallabat, MD
-
Alexis Olivia Kashat, FNP-C
-
Hillary Little, NP-C
-
Rakel K Sami, NP
-
Jabir Kamal Akhtar, M.D.
-
Brianna D Stammen, FNP-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180625002002 | MI | Part B Supplier - Clinic/Group Practice | 4587919055 |
Receives reassigned benefits from 9 practitioners Practice locations: Dearborn Heights, MI; Flint, MI; Shelby Township, MI |
| O20180920003506 | MI | DME Supplier - Physician - Internal Medicine | 4587919055 | Practice locations: Beverly Hills, MI |
National Provider Directory
- Tax ID family
- Affiliated Knee Pain PLLC
Locations
31333 Southfield Rd
Ste 103
Beverly Hills, MI 48025
Phone (248) 952-9190
8565 N Silvery Ln
#405
Dearborn Heights, MI 48127
8565 N Silvery Ln
Ste 405
Dearborn Heights, MI 48127
Phone (313) 512-7111
45445 Mound Rd
Ste 105
Shelby Township, MI 48317
Phone (248) 952-9190
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | 4301070138 | MI | Yes |
Addresses
Primary practice location
31333 Southfield Rd Ste 103
Beverly Hills, MI 48025-5473
Mailing address
45445 Mound Rd Ste 105
Shelby Township, MI 48317-5178
Phone (866) 207-5105
Other practice location 1
45445 Mound Rd Ste 105
Shelby Township, MI 48317-5178
Phone (866) 207-5105
Other names
- Nu Life Medical
Other providers in Beverly Hills, MI
- A. Martin Lerner, MD,PC
- Hassan Hassan-Khalil Abdallah
- Cother Abdo
- Hannah Abels
- Advanced Implant and Cosmetic Dentistry
- Zaki Afzal
- Hyunyoung Ahn
- Deane Aikins
- Zeynep Alpay Savasan
- Perry Ross Altman
All providers in Beverly Hills, MI · Internal Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.