Individual provider Active NPI

Basma Ali Khan

  • Student in an Organized Health Care Education/Training Program
  • Saint Cloud, MN
National Provider Identifier
1053256297
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1555 Northway Dr Ste 200
Saint Cloud, MN 56303-4913
Phone
(320) 240-3157
NPI assigned
Apr 22, 2026
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

1555 Northway Dr Ste 200
Saint Cloud, MN 56303-4913

Mailing address

1555 Northway Dr Ste 200
Saint Cloud, MN 56303-4913

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20260622003407 MN Order and Referring Only - Family PracticePractitioner - Family Practice 6305319344

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1776816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1053256297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 NORTHWAY DR STE 200",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 NORTHWAY DR STE 200",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034913",
            "telephone_number": "320-240-3157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "BASMA ALI",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2026-04-22",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "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 Saint Cloud, MN

Sources for this page

Verify at the official NPI Registry.