Individual provider Active NPI

Omar Ahmed Khan, MD

  • Internal Medicine Physician
  • Detroit, MI
National Provider Identifier
1730617135
Registry record updated Aug 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301504190 Issued in MI
Practice address
2799 W Grand Blvd
Detroit, MI 48202-2608
Phone
(313) 916-1888
NPI assigned
May 30, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301112289 MI
Sleep Medicine (Internal Medicine) Physician 207RS0012X 4301504190 MI
Internal Medicine Physician 207R00000X 4301504190 MI Primary

Addresses

Primary practice location

2799 W Grand Blvd
Detroit, MI 48202-2608

Mailing address

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

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
I20210629000539 MI Practitioner - Internal MedicinePractitioner - Sleep Medicine 2961778832 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Sleep Medicine
Education
Central Michigan College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

205 N E Ave
Henry Ford Allegiance Sleep Health Center
Jackson, MI 49201-1753
Phone (517) 205-4750

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Pathology Current Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Jun 10, 2021 Accepting new patients
Henry Ford Health System CurrentSince Jun 10, 2021 Accepting new patients
Henry Ford Health System Internal Medicine CurrentSince Jun 10, 2021 Accepting new patients
W. a. Foote Memorial Hospital, Inc Internal Medicine Current Accepting new patients
Henry Ford Health System Current Accepting new patients
W.a. Foote Memorial Hospital, Inc Internal Medicine CurrentSince Jun 10, 2021 Accepting new patients
Wa Foote Memorial Hospital, Inc Past Accepting new patients

Locations

23050 West Rd
Brownstown Twp, MI 48183
Phone (734) 287-9880

43650 Garfield Rd
Clinton Twp, MI 48038
Phone (586) 263-0820

1 Ford Pl
Ste 2E
Detroit, MI 48202
Phone (313) 874-3953

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

3031 W Grand Blvd
Detroit, MI 48202
Phone (313) 871-3751

159 Kercheval Ave
Grosse Pointe Farms, MI 48236
Phone (313) 640-1000

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

205 N East Ave
#4
Jackson, MI 49201

130 N Sherman St
Leslie, MI 49251
Phone (517) 205-2500

39450 W Twelve Mile Rd
Novi, MI 48377
Phone (248) 344-0710

110 E 2nd St
Royal Oak, MI 48067
Phone (248) 546-2110

3500 15 Mile Rd
Sterling Hts, MI 48310
Phone (586) 977-9300

Interoperability endpoints

  • Direct secure messaging: okhan448691@direct.hfhs.org

Organizations & group practices 8

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 1

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": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1730617135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "313-916-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "OMAR",
        "middle_name": "AHMED",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-30",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301112289",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "MI",
            "license": "4301504190",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301504190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.