Khadija Motan

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085-010102 Issued in IL

Practice address

2320 E 93Rd St
Chicago, IL 60617-3909

Phone

(773) 967-5430

Fax

(773) 967-4205

NPI assigned

Sep 9, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IL, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: khadija.motan.1@19285.direct.athenahealth.com
• Direct secure messaging: kmotan376395@direct.myadvocateaurora.org

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.

• Permian Basin Kidney Center Inc

  • Nephrology Physician
  • Odessa, TX
  • NPI 1285199026
  Medicare reassignment

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

{
    "created_epoch": "1662681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1003537739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 E 93RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606173909",
            "telephone_number": "773-967-5430",
            "fax_number": "773-967-4205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4125 N Keystone Ave Apt 304",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606412494",
            "country_code": "US",
            "telephone_number": "630-656-0808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOTAN",
        "first_name": "KHADIJA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-09",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-010102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmotan376395@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2320 E 93rd St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606173909",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2320 E 93rd St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606173909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lagha Mostajabi
• Reza Mostofi, DENTIST
• Yifat Mostofsky, FNP-BC
• Arthur H Moswin, M.D.
• Leticia Mota
• Guy Urban Motanky, PH.D.
• Courtney Marie Moteberg
• Mother'S Care & Health Equipment Inc
• Mother'S Druthers
• Mother'S Touch Home Health, Inc.

• Physician Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.