Individual provider Active NPI

Naji M Khairallah, MD

  • Internal Medicine Physician
  • Paw Paw, MI
National Provider Identifier
1710963970
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301052706 Issued in MI
Practice address
451 Health Pkwy
Suite F
Paw Paw, MI 49079-8242
Phone
(269) 655-3080
Fax
(269) 655-0761
NPI assigned
Dec 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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 4301052706 MI Primary

Addresses

Primary practice location

451 Health Pkwy
Suite F
Paw Paw, MI 49079-8242

Mailing address

601 John St
Box 42
Kalamazoo, MI 49007-5341
Phone (269) 341-7806

Other identifiers 2

IdentifierTypeStateIssuer
238601OtherMIMEDICARE RURAL HEALTH CLINIC NUMBER
CA4396OtherMIRAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct

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
I20040322000151 MI Practitioner - Internal Medicine 5193616118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Osteopathic Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bronson Lakeview HospitalGroup PAC ID 9032008495, 72 clinicians

Practice addresses (Care Compare)

451 Health Pkwy
Paw Paw, MI 49079-8242

451 Health Pkwy E
Bronson Lakeview Pediatrics
Paw Paw, MI 49079-8242
Phone (269) 655-3090

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301052706MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Lakeview Hospital Internal Medicine CurrentSince Feb 1, 2009 Accepting new patients
Bronson Lakeview Hospital CurrentSince Feb 1, 2009 Accepting new patients

Locations

300 North Ave
Fl 2
Battle Creek, MI 49017
Phone (269) 245-5862

601 John St
#42
Kalamazoo, MI 49007
Phone (269) 341-7806

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

404 Hazen St
Ste 101
Paw Paw, MI 49079
Phone (269) 657-2550

404 Hazen St
Paw Paw, MI 49079
Phone (269) 657-1417

451 Health Pkwy
Paw Paw, MI 49079
Phone (269) 655-1725

451 Health Pkwy
Ste F
Paw Paw, MI 49079
Phone (269) 655-3080

Interoperability endpoints

  • Direct secure messaging: direct@direct.bronsonhg.org
  • Direct secure messaging: nkhairallah10584@direct.bronsonhg.org

Organizations & group practices 2

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": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1710963970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JOHN ST",
            "address_2": "BOX 42",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-341-7806",
            "fax_number": "269-341-8743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 HEALTH PKWY",
            "address_2": "SUITE F",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490798242",
            "telephone_number": "269-655-3080",
            "fax_number": "269-655-0761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAIRALLAH",
        "first_name": "NAJI",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301052706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RURAL HEALTH CLINIC NUMBER",
            "identifier": "238601",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA4396",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Paw Paw, MI

Sources for this page

Verify at the official NPI Registry.