Mohammad Kisra Haddad, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

5101027346 Issued in MI

Practice address

18471 Haggerty Road
Northville, MI 48168

Phone

(248) 639-2300

NPI assigned

Oct 20, 2015

Last updated

Oct 23, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• State of Michigan

  dba Southeast Michigan Psychiatric Hospital Child and Adolescent Services

  • Psychiatric Hospital
  • Northville, MI
  • NPI 1053480905
  NPD (past)
• State of Michigan Office of Financial Management

  dba State of Michigan

  • Psychiatric Hospital
  • Northville, MI
  • NPI 1508883299

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1445299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792713600000",
    "number": "1780056549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18471 HAGGERTY ROAD",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "48168",
            "telephone_number": "248-639-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18471 HAGGERTY ROAD",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "48168",
            "telephone_number": "248-639-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISRA HADDAD",
        "first_name": "MOHAMMAD",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-20",
        "last_updated": "2026-10-23",
        "certification_date": "2026-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "5101027346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fatima A Khan, RDN
• Hitesh V Khatri
• Amie L Kilcoyne
• Bouh Hur Kim, M.D
• Marquita M King
• David Mark Klein, LMSW
• Aric Klos
• Delfina Kluska, BCBA
• Advaith Kocheri Agithakumar
• Rodica Kocur, TLLP

• Psychiatry Physician in Northville, MI
• Providers in Northville, MI by specialty
• Psychiatry Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.

Verify at the official NPI Registry.