Active NPI
Mohammad M Khaghany, M.D.
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Kalamazoo, MI
National Provider Identifier
1790733129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- 039427
- Practice address
- 1722 Shaffer St
Suite 2
Kalamazoo, MI 49048-1633 - Phone
- (269) 343-1555
- Fax
- (269) 343-3209
- NPI assigned
- May 5, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 039427 | MI | Primary |
Addresses
Primary practice location
1722 Shaffer St
Suite 2
Kalamazoo, MI 49048-1633
Mailing address
1722 Shaffer St
Suite 2
Kalamazoo, MI 49048-1633
Phone (269) 343-1555
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4240560 | Medicaid | MI | |
| 03931791 | Other | MI | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 039427 | MI | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194307200000",
"number": "1790733129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1722 SHAFFER ST",
"address_2": "SUITE 2",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490481633",
"telephone_number": "269-343-1555",
"fax_number": "269-343-3209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1722 SHAFFER ST",
"address_2": "SUITE 2",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490481633",
"telephone_number": "269-343-1555",
"fax_number": "269-343-3209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAGHANY",
"first_name": "MOHAMMAD",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-05",
"last_updated": "2007-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "MI",
"license": "039427",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4240560",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "03931791",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.