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

Q: 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.

Q: What is Ammar Ghanem's specialty?

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

Q: 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 6 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.

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: October 25, 2026.

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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 Mclaren Flint, 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

Phone(260) 416-5892

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

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Other Identifiers 5

Medicaid2626420OH

Other7424707IN · Aetna

Other000000658707IN · Anthem

Medicaid1346790896MI

Medicaid200982500IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignment

Medicare enrollment records show Ammar Ghanem reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ammar Ghanem MD PLLC

1.9 mi

Pulmonary Disease

950 W AVON RD, A2
Rochester Hills, MI 48307

Reassigned Medicare billing, Michigan enrollment

NPI 1346790896 (248) 651-6430

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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

Irrigation and suction of lung airways to obtain cells using an endoscope 31624

This is a procedure where a thin, flexible tube called an endoscope is inserted through your mouth into the lungs. A small amount of saline is then introduced to wash the airways. The fluid, along with cells from the lung, is suctioned back for analysis.

27 services27 patients

Test to determine lung volumes using sensors 94726

This test, called spirometry, measures lung capacity using sensors. You breathe into a mouthpiece attached to a device that records the amount and rate of air you inhale and exhale. It helps diagnose and monitor lung conditions.

26 services25 patients

Test to examine how well the lungs exchange gases 94729

This is a test called a pulmonary function test, which helps understand the efficiency of your lungs. It measures how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and remove carbon dioxide from your blood.

26 services25 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

This procedure measures how air flows in and out of your lungs. It's done before and after medication to see if the treatment improves your breathing. It's a simple, non-invasive test that involves breathing into a device called a spirometer.

25 services24 patients

Test to measure expiratory airflow and volume changes before and after medication administration 94060

22 services22 patients

Test to determine lung volumes using sensors 94726

22 services22 patients

Test to determine lung volumes using gas dilution or washout 94727

This test measures lung volumes by either diluting or washing out a known amount of gas in your lungs. You'll breathe in a harmless gas, then exhale. The exhaled air is analyzed to assess your lung capacity and function.

22 services22 patients

Test to examine how well the lungs exchange gases 94729

22 services22 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

22 services22 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

20 services17 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

14 services13 patients

Removal of implanted eardrum tube under anesthesia 69424

This procedure involves the removal of a previously inserted tube in your eardrum while you're under anesthesia. This tube may have been placed to help drain fluid or to prevent ear infections. The process is safe, quick, and you won't feel any discomfort.

13 services12 patients

Sleep study in sleep lab (6 years or older) 95810

A sleep study in a sleep lab is a non-invasive overnight test that monitors your body while you sleep. It helps doctors understand your sleep patterns and identify any issues like sleep apnea or insomnia. You'll be connected to equipment that tracks your heart rate, brain waves, breathing, and movements.

13 services13 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

13 services13 patients

Hospital Affiliations CMS Care Compare 5

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

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

Beaumont Hospital, Troy

Acute Care Hospitals · Troy, MI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number230269

Location44201 Dequindre RoadTroy, MI 48085 · 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