Individual provider Active NPI

Abdul Hafeez Khan, M.D.

  • Psychiatry Physician
  • New Orleans, LA
National Provider Identifier
1003945221
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
015368 Issued in LA
Practice address
719 Elysian Fields Ave
New Orleans, LA 70117-8511
Phone
(504) 942-8101
Fax
(504) 942-8242
NPI assigned
Mar 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 015368 LA Primary

Addresses

Primary practice location

719 Elysian Fields Ave
New Orleans, LA 70117-8511

Mailing address

9 Chateau Mouton Dr
Kenner, LA 70065-1902
Phone (504) 467-4547

Other identifiers 1

IdentifierTypeStateIssuer
1914967MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040510000771 LA Practitioner - Psychiatry 2961396296 Practice locations: Kenner, LA

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

716 Village Rd
Kenner, LA 70065-2751
Phone (504) 464-8895

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
015368LAMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1003945221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CHATEAU MOUTON DR",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700651902",
            "telephone_number": "504-467-4547",
            "fax_number": "504-467-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 ELYSIAN FIELDS AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701178511",
            "telephone_number": "504-942-8101",
            "fax_number": "504-942-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "ABDUL",
        "middle_name": "HAFEEZ",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "015368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1914967",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.