Individual provider Active NPI

Amelia Aynaz Mahmoodzadeh Khoei

  • Student in an Organized Health Care Education/Training Program
  • Ann Arbor, MI
National Provider Identifier
1760129076
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
4351048895 Issued in MI
Practice address
1500 E Medical Center Dr.
Taubman Center, 2ND Floor, Reception C
Ann Arbor, MI 48109-5330
Phone
(734) 936-7030
Fax
(734) 936-9127
NPI assigned
May 18, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4351048895 MI Primary

Addresses

Primary practice location

1500 E Medical Center Dr.
Taubman Center, 2ND Floor, Reception C
Ann Arbor, MI 48109-5330

Mailing address

1500 E Medical Center Dr.
Taubman Center, 2ND Floor, Reception C
Ann Arbor, MI 48109-5330
Phone (734) 936-7030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4351048895MIMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1652832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1760129076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR.",
            "address_2": "TAUBMAN CENTER, 2ND FLOOR, RECEPTION C",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095330",
            "telephone_number": "734-936-7030",
            "fax_number": "734-936-9127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR.",
            "address_2": "TAUBMAN CENTER, 2ND FLOOR, RECEPTION C",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095330",
            "telephone_number": "734-936-7030",
            "fax_number": "734-936-9127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHMOODZADEH KHOEI",
        "first_name": "AMELIA",
        "middle_name": "AYNAZ",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-18",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351048895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.