Individual provider Active NPI

Ahmed Khan, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Atlanta, GA
National Provider Identifier
1033436100
Registry record updated Apr 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1364 Clifton Rd NE
Atlanta, GA 30322-1059
Phone
(312) 371-1717
NPI assigned
Apr 28, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1364 Clifton Rd NE
Atlanta, GA 30322-1059

Mailing address

1364 Clifton Rd NE
Atlanta, GA 30322-1059

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20141107001887 CA Practitioner - Psychiatry 4688822539 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
125998CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda Health System CurrentSince Sep 25, 2014 Accepting new patients
Alameda Health System CurrentSince Sep 25, 2014 Accepting new patients

Locations

15400 Foothill Blvd
Bldg E
Castro Valley, CA 94578
Phone (510) 895-4200

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

Organizations & group practices 2

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": "1272412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272499200000",
    "number": "1033436100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1364 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1364 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221059",
            "telephone_number": "312-371-1717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "AHMED",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-28",
        "last_updated": "2010-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.