Mariam Khalid

Key facts

NPI

1831479005

Entity type

Individual (NPI type 1)

Primary specialty

Internal Medicine Physician 207R00000X

License

69645 (WI)

Practice address

824 Illinois Ave
Stevens Point, WI 54481

Phone

(715) 342-7725

NPI assigned

Aug 19, 2011

Sex

Female

Sole proprietor

Yes

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Carle Health Care Incorporated Internal Medicine Physician · Urbana, IL · NPI 1154653947
  Medicare reassignment Care Compare group NPD IL · INTERNAL MEDICINE
• Carle West Physician Group Inc Family Medicine Physician · Normal, IL · NPI 1467074138
  Medicare reassignment Care Compare group NPD IL
• Aspirus Stevens Point Hospital & Clinics, Inc. General Acute Care Hospital · Stevens Point, WI · NPI 1538112230
  Medicare reassignment NPD WI
• Advocate Health and Hospitals Corporation Multi-Specialty Clinic/Center · Oak Brook, IL · NPI 1700824455
  Medicare reassignment NPD IL
• Carle Health Care Incorporated Durable Medical Equipment & Medical Supplies · Champaign, IL · NPI 1235452996
  Care Compare group
• Carle West Physician Group Inc Durable Medical Equipment & Medical Supplies · Bloomington, IL · NPI 1033866801
  Care Compare group
• Aspirus Stevens Point Hospital & Clinics, Inc. Clinic/Center · Stevens Point, WI · NPI 1679706022
  NPD
• Advocate Health & Hospitals Corporation Medical Specialty Clinic/Center · Oak Lawn, IL · NPI 1912936014
  NPD
• Advocate Health and Hospitals Corporation Children's Hospital · Oak Lawn, IL · NPI 1508315516
  NPD

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carle Bromenn Medical Center General Acute Care Hospital · Normal, IL · NPI 1962424036
  Care Compare affiliation Hospital

Medicare Care Compare profile

Specialty

Internal Medicine

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carle West Physician Group Inc (282 clinicians)
Carle Health Care Incorporated (1,592 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carle Bromenn Medical Center Hospital · Normal, IL · CCN 140127

Medicare participation

Medicare fee-for-service enrollment

Enrolled (2 enrollments) in WI, IL

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkhalidmd311878@carlehiedirect.net

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 3, 2019.

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1831479005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 ILLINOIS AVE",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544813112",
            "telephone_number": "715-342-7725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 ILLINOIS AVE",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "54481",
            "telephone_number": "715-342-7725"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Gustave L Levy Pl",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296504",
            "country_code": "US",
            "telephone_number": "212-241-1653",
            "fax_number": "212-289-6393",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Gustave L Levy Pl",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100296504",
            "country_code": "US",
            "telephone_number": "212-241-1653",
            "fax_number": "212-289-6393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHALID",
        "first_name": "MARIAM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-19",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "277565",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "69645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevens Point, WI

• Debra K Kearns, OTR L
• Jacqueline Leigh Keating
• Karen H Keil, MD
• Elizabeth Rose Kelly, DPT
• Paige Kermendy
• Arshad Khan, M.D.
• Zachary Khalil Khelah, LPC
• Tracy L. Kiener, PT
• Teresa R Kievet, RN
• Aaron King, MA LMFT-IT

All providers in Stevens Point, WI · Internal Medicine Physician in Wisconsin