Individual provider Active NPI

Abraham Kisule

  • Internal Medicine Physician
  • Southfield, MI
National Provider Identifier
1790422665
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101028467 Issued in MI
Practice address
22301 Foster Winter Dr
Southfield, MI 48075-3707
Phone
(248) 849-3541
NPI assigned
May 12, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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 5101028467 MI Primary
Emergency Medicine Physician 207P00000X 5101028467 MI
Hematology & Oncology Physician 207RH0003X 5101028467 MI

Addresses

Primary practice location

22301 Foster Winter Dr
Southfield, MI 48075-3707

Mailing address

22301 Foster Winter Dr
Southfield, MI 48075-3707
Phone (248) 849-3541

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
I20250410002796 MI Order and Referring Only - Hematology/OncologyPractitioner - Internal MedicinePractitioner - Hematology/Oncology 6901320936

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5101028467MIMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: akisule753407@direct.hfhs.org

NPI Registry JSON

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

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1790422665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22301 FOSTER WINTER DR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753707",
            "telephone_number": "248-849-3541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22301 FOSTER WINTER DR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753707",
            "telephone_number": "248-849-3541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISULE",
        "first_name": "ABRAHAM",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-12",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101028467",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101028467",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MI",
            "license": "5101028467",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.