Organization Active NPI

Minoo Khetarpal MD PLLC

  • Internal Medicine Physician
  • Saginaw, MI
National Provider Identifier
1811934193
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MINOO KHETARPAL MD PLLC
Practice address
1320 N Michigan Ave
Suite 4
Saginaw, MI 48602-4751
Phone
(989) 755-5500
NPI assigned
Jun 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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

Authorized official

Name
Minoo Khetarpal, M.D.NPI 1033197942
Title
Owner
Phone
(989) 755-5500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1320 N Michigan Ave
Suite 4
Saginaw, MI 48602-4751

Mailing address

4449 Fashion Square Blvd
Saginaw, MI 48603-5217
Phone (989) 790-0007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040604000051 MI Part B Supplier - Clinic/Group Practice 4981686714 Receives reassigned benefits from 1 practitioner
Practice locations: Saginaw, MI

National Provider Directory

National Provider Directory

Locations

1320 N Michigan Ave
Ste 4
Saginaw, MI 48602
Phone (989) 755-5500

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358985600000",
    "number": "1811934193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4449 FASHION SQUARE BLVD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486035217",
            "telephone_number": "989-790-0007",
            "fax_number": "989-790-7547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 N MICHIGAN AVE",
            "address_2": "SUITE 4",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486024751",
            "telephone_number": "989-755-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINOO KHETARPAL MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2013-01-24",
        "status": "A",
        "authorized_official_last_name": "KHETARPAL",
        "authorized_official_first_name": "MINOO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-755-5500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.