Individual provider Active NPI

Mahmood A Khalid, MD

  • Diagnostic Radiology Physician
  • Pontiac, MI
National Provider Identifier
1730107178
Registry record updated Mar 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
035499 Issued in MI
Practice address
461 W Huron St
Pontiac, MI 48341-1601
Phone
(248) 857-7515
Fax
(248) 857-7524
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 035499 MI Primary

Addresses

Primary practice location

461 W Huron St
Pontiac, MI 48341-1601

Mailing address

PO Box 77000
Dept 160901
Detroit, MI 48277-1609
Phone (248) 857-7515

Other identifiers 4

IdentifierTypeStateIssuer
2707671MedicaidMI
CI8050OtherMIMEDICARE RR GROUP
4626456MedicaidMI
0E01133OtherMIBCBS OF MI GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
035499MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
NDS Radiology PLLC PastSince Feb 23, 2025 Accepting new patients
Khalid & Associates MD PC Diagnostic Radiology PastSince Jan 1, 1991 Accepting new patients
United Eagle Imaging, LLC Diagnostic Radiology Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300147200000",
    "number": "1730107178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 77000",
            "address_2": "DEPT 160901",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482771609",
            "telephone_number": "248-857-7515",
            "fax_number": "734-677-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 W HURON ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483411601",
            "telephone_number": "248-857-7515",
            "fax_number": "248-857-7524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALID",
        "first_name": "MAHMOOD",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2011-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "035499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2707671",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR GROUP",
            "identifier": "CI8050",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4626456",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI GROUP",
            "identifier": "0E01133",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.