Active NPI
Mohammad Kisra Haddad, DO
- Psychiatry Physician
- Westland, MI
National Provider Identifier
1780056549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 5101027346
- Practice address
- 30901 Palmer Rd
Westland, MI 48186-9529 - Phone
- (734) 367-8400
- NPI assigned
- Oct 20, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 5101027346 | MI | Primary |
Addresses
Primary practice location
30901 Palmer Rd
Westland, MI 48186-9529
Mailing address
30901 Palmer Rd
Westland, MI 48186-9529
Phone (734) 367-8400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3434247 | Medicaid | MI |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210702000683 | MI | Order and Referring Only - Psychiatry | 4688075229 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101027346 | MI | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775952000000",
"number": "1780056549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30901 PALMER RD",
"city": "WESTLAND",
"state": "MI",
"postal_code": "481869529",
"telephone_number": "734-367-8400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30901 PALMER RD",
"city": "WESTLAND",
"state": "MI",
"postal_code": "481869529",
"telephone_number": "734-367-8400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISRA HADDAD",
"first_name": "MOHAMMAD",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-10-20",
"last_updated": "2026-04-12",
"certification_date": "2026-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "5101027346",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3434247",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Westland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.