Basel Khatib, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301058311 Issued in MI

Practice address

5728 Schaefer Rd Ste 101
Dearborn, MI 48126-2287

Phone

(313) 624-3005

Fax

(313) 846-4547

NPI assigned

Jan 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 16, 2016 through Feb 16, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Basel Khatib, M.D., P.C.

  • Pediatrics Physician
  • Dearborn, MI
  • NPI 1285809897
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301875200000",
    "number": "1710967674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5728 SCHAEFER RD STE 101",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262287",
            "telephone_number": "313-624-3005",
            "fax_number": "313-846-4547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5728 SCHAEFER RD STE 101",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262287",
            "telephone_number": "313-624-3005",
            "fax_number": "313-846-4547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHATIB",
        "first_name": "BASEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2011-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301058311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4305600",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ammar Khasrachi
• Sama Khasrachi
• Ali H Khater, LLMSW
• Kamilia Khatib-Shahidi
• Assma Khatib, LPC
• Samah Khatib, BCBA, LBA
• Kenda I Khattab
• Rolla Khattab
• Adnan A. Khazaal, D.D.S.
• Huda I. Khazendar, MA

• Pediatrics Physician in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2011; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.