Individual provider Active NPI

Kenni Jae Allen El-Amin, MD

  • Internal Medicine Physician
  • Dearborn, MI
National Provider Identifier
1952532749
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301094292 Issued in MI
Practice address
18101 Oakwood Blvd
Dearborn, MI 48124-4089
Phone
(313) 436-2578
NPI assigned
Jul 28, 2009
Last updated
Jun 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301094292 MI Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 4301094292 MI

Addresses

Primary practice location

18101 Oakwood Blvd
Dearborn, MI 48124-4089

Mailing address

5649 Golf Pointe Dr
Clarkston, MI 48348-5148
Phone (810) 423-5470

Other practice location 1

826 W King St
Owosso, MI 48867-2120
Phone (989) 726-4978

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
I20131101001009 MI Practitioner - Internal Medicine 4082849849 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Michigan State University College of Human Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial HospitalGroup PAC ID 8527976497, 210 clinicians

Practice addresses (Care Compare)

826 W King St
Memorial Medical Associates
Owosso, MI 48867-2120
Phone (989) 723-5211

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.58 of 100Reported as group
Quality
58.15
Promoting interoperability
100
Improvement activities
40
Cost
74.45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301094292MIMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Internal Medicine Current Accepting new patients
Memorial Hospital CurrentSince Jun 29, 2019 Accepting new patients
Memorial Hospital CurrentSince Jun 29, 2019 Accepting new patients
Inpatient Consultants of Michigan PC Internal Medicine CurrentSince Apr 2, 2018 Accepting new patients
Memorial Hospital Past Accepting new patients
Pleasant View Shiawassee County Medical Care Facility Past Accepting new patients
Memorial Hospital Past Accepting new patients

Locations

1014 E Grand River Ave
Brighton, MI 48116
Phone (810) 220-5222

9000 Peet Rd
Chesaning, MI 48616
Phone (989) 720-2273

1 William Carls Dr
Commerce Twp, MI 48382
Phone (248) 227-5500

18101 Oakwood Blvd
Dearborn, MI 48124
Phone (313) 593-8780

239 N State Rd
Ste 101
Owosso, MI 48867
Phone (989) 725-8688

275 N Caledonia Dr
Owosso, MI 48867
Phone (989) 743-3491

826 W King St
Owosso, MI 48867
Phone (989) 720-2273

3337 Britton Rd
Perry, MI 48872
Phone (517) 625-3004

Interoperability endpoints

  • Direct secure messaging: kallenelamin1222863@epic00.shdirect.org

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1952532749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5649 GOLF POINTE DR",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483485148",
            "telephone_number": "810-423-5470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18101 OAKWOOD BLVD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481244089",
            "telephone_number": "313-436-2578"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "826 W King St",
            "address_purpose": "LOCATION",
            "city": "Owosso",
            "state": "MI",
            "postal_code": "488672120",
            "country_code": "US",
            "telephone_number": "989-726-4978",
            "fax_number": "989-729-4048",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLEN EL-AMIN",
        "first_name": "KENNI",
        "middle_name": "JAE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-28",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301094292",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MI",
            "license": "4301094292",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

Verify at the official NPI Registry.