Active NPI
Masood Khan, M.D.
- Pediatrics Physician
- Scottsbluff, NE
National Provider Identifier
1003822941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 21499
- Practice address
- 2 W 42ND St
Scottsbluff, NE 69361-4669 - Phone
- (308) 630-1811
- Fax
- (308) 630-1838
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 21499 | NE | Primary |
Addresses
Primary practice location
2 W 42ND St
Scottsbluff, NE 69361-4669
Mailing address
2 W 42ND St
Scottsbluff, NE 69361-4669
Phone (308) 630-1811
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21499 | Other | NE | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21499 | NE | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regional West Physicians Clinic | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003822941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 W 42ND ST",
"city": "SCOTTSBLUFF",
"state": "NE",
"postal_code": "693614669",
"telephone_number": "308-630-1811",
"fax_number": "308-630-1838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 W 42ND ST",
"city": "SCOTTSBLUFF",
"state": "NE",
"postal_code": "693614669",
"telephone_number": "308-630-1811",
"fax_number": "308-630-1838"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "MASOOD",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NE",
"license": "21499",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "21499",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Scottsbluff, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.