Mohammed Alkhateeb, MD
Individual provider Active NPI Cardiovascular Disease Physician · Marlette, MI
NPI 1962404517 · NPPES record last updated Jan 27, 2023
Key facts
- NPI
- 1962404517
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- 35074589 (OH)
- Practice address
- 2750 Main St Ste 3
Marlette, MI 48453-1100 - Phone
- (989) 635-4023
- Fax
- (989) 635-5297
- NPI assigned
- Aug 12, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Covenant Medical Center, Inc.
Practice addresses (Care Compare)
2750 Main St
Suite 3
Marlette, MI 48453-1100
Phone (989) 635-4023
Hospital & facility affiliations
- Marlette Regional Hospital
- Hills & Dales General Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081104000395 | MI | Practitioner - Cardiovascular Disease (Cardiology) | 9537154802 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35074589 | OH | MD | Cardiovascular Disease Physician |
| 27333 | TN | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Covenant Medical Center, Inc | Current |
Accepting new patients | |
| Covenant Medical Center, Inc. | Current | Accepting new patients | |
| Fauster Cameron Inc. | Past | Accepting new patients | |
| Bolivar General Hospital, Inc. | Past | Accepting new patients | |
| Bolivar General Hospital, Inc. | Past | Accepting new patients |
Locations
4672 Hill St
Cass City, MI 48726
Phone (989) 872-5010
3559 Pine St
Deckerville, MI 48427
Phone (810) 376-2835
2750 Main St
Ste 3
Marlette, MI 48453
Phone (989) 635-4023
1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220
Interoperability endpoints
- malkhateeb136987@direct.covenanthealthcare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 35074589 | OH | Yes |
Addresses
Primary practice location
2750 Main St Ste 3
Marlette, MI 48453-1100
Mailing address
2750 Main St Ste 3
Marlette, MI 48453-1100
Phone (989) 635-4023
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4455715 | Medicaid | MI | |
| 060069949 | Other | OH | RAILROAD MEDICARE |
| 2360823 | Medicaid | OH |
Other providers in Marlette, MI
All providers in Marlette, MI · Cardiovascular Disease Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.