AMMAR GHANEM MD
NPI 1528026424
Internal Medicine - Pulmonary Disease in Rochester Hills, MI

Active since May 02, 2006PECOS EnrolledAccepts Medicare Assignment
75 BARCLAY CIR STE 205, ROCHESTER HILLS, MI 48307(260) 416-5892(260) 416-5897 Get Directions Write a Review

NPPES record last updated: October 21, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ammar Ghanem Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AMMAR GHANEM MD (NPI 1528026424) is an individual pulmonary disease provider in Rochester Hills, Michigan, licensed in Michigan (4301111042) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Henry Ford Health Hospital, and is a graduate of Other (1994).

NPPES Registry Identity

NPI1528026424
Entity TypeIndividualMale
Primary Taxonomy207RP1001X
Provider Legal NameAMMAR GHANEMCredential: MD
Location Address75 BARCLAY CIR STE 205Rochester Hills, MI 48307-5821
Mailing Address75 Barclay Cir Ste 205Rochester Hills, MI 48307-5821 · (248) 651-6430 · Fax (260) 416-5897
Fax(260) 416-5897
Sole ProprietorNo
Medical School CMSOtherGraduated 1994
Enumeration DateMay 2, 2006
Last NPPES UpdateOctober 21, 2020
NPPES CertifiedOctober 21, 2020
NPI 1528026424 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
Licenses Licensed in MI · 4301111042 Licensed in IN · 01067395 Licensed in OH · 35085090
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
Also ListedInternal MedicineTaxonomy 207R00000X · License 35085090 (OH)
Also ListedInternal Medicine · Critical Care MedicineTaxonomy 207RC0200X · License 01067395 (IN), 35085090 (OH)
Also ListedInternal Medicine · Sleep MedicineTaxonomy 207RS0012X · License 01067395 (IN)
75 BARCLAY CIR STE 205, Rochester Hills, MI 48307

Other Identifiers 5

Medicaid2626420OH
Other7424707IN · Aetna
Other000000658707IN · Anthem
Medicaid1346790896MI
Medicaid200982500IN

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Ammar Ghanem Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9537058193
PECOS Enrollment IDI20161227001349
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 20

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
774 services283 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
363 services128 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
172 services160 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
85 services48 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
76 services53 patients
Critical care, each additional 30 minutes 99292
Critical care refers to special attention given to patients facing life-threatening conditions. Each additional 30 minutes indicates the extension of this specialized care. This might include close monitoring, medication adjustments, and immediate interventions as needed.
42 services32 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Henry Ford Health Hospital

Acute Care Hospitals · Detroit, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230053
Location2799 W Grand BlvdDetroit, MI 48202 · Wayne County
Emergency services Birthing friendly

Mclaren Flint

Acute Care Hospitals · Flint, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230141
Location401 S Ballenger HighwayFlint, MI 48532 · Genesee County
Emergency services Birthing friendly

Mclaren Lapeer Region

Acute Care Hospitals · Lapeer, MI
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230193
Location1375 N Main StLapeer, MI 48446 · Lapeer County
Emergency services Birthing friendly

Mclaren Oakland

Acute Care Hospitals · Pontiac, MI
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230207
Location50 N Perry StPontiac, MI 48342 · Oakland County
Emergency services

Ascension Providence Rochester Hospital

Acute Care Hospitals · Rochester, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230254
Location1101 W University DriveRochester, MI 48307 · Oakland County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48307 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$134.28 typical visit price
range $58.04 – $177.36
Typical copayment $33.57 (range $14.51 – $44.34)
Most-billed visit code 99204
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
100%111 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 18

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
16 suppliers67 claims67 services$33.66 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
15 suppliers89 claims89 services$81.44 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
13 suppliers87 claims211 services$33.08 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
7 suppliers15 claims76 services$18.21 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
10 suppliers29 claims136 services$15.05 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
11 suppliers41 claims41 services$52.45 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine (Pulmonary Disease)
75 BARCLAY CIR STE 205
ROCHESTER HILLS, MI 48307
Internal Medicine (Pulmonary Disease)
75 BARCLAY CIR STE 205
ROCHESTER HILLS, MI 48307
Clinic/Center
75 BARCLAY CIR STE 205
ROCHESTER HILLS, MI 48307
Dentist (Oral and Maxillofacial Surgery)
75 BARCLAY CIR STE 205
ROCHESTER HILLS, MI 48307
Internal Medicine (Pulmonary Disease)
75 BARCLAY CIR STE 205
ROCHESTER HILLS, MI 48307
Internal Medicine (Pulmonary Disease)
75 BARCLAY CIR STE 205
ROCHESTER HILLS, MI 48307
Internal Medicine (Pulmonary Disease)
75 BARCLAY CIR STE 205
ROCHESTER HILLS, MI 48307
Internal Medicine (Pulmonary Disease)
75 BARCLAY CIR STE 205
ROCHESTER HILLS, MI 48307

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ammar Ghanem's NPI number?

The NPI number for Ammar Ghanem is 1528026424. It was assigned to this individual provider in the NPPES registry on May 2, 2006.

Where is Ammar Ghanem located?

Ammar Ghanem practices at 75 Barclay Cir Ste 205, Rochester Hills, MI 48307. The listed phone number is (260) 416-5892.

What is Ammar Ghanem's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

Is Ammar Ghanem enrolled in Medicare?

Yes. Ammar Ghanem is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Ammar Ghanem accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and Priority Health list Ammar Ghanem as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Ammar Ghanem affiliated with any hospitals?

According to CMS data, Ammar Ghanem is affiliated with Henry Ford Health Hospital, Mclaren Flint, Mclaren Lapeer Region, Mclaren Oakland and Ascension Providence Rochester Hospital.

When was this NPI record last updated?

The NPPES record for Ammar Ghanem was last updated on October 21, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.