Individual provider Active NPI

Muhammad Talha Khan, M.D.

  • Pulmonary Disease Physician
  • Saint Croix Falls, WI
National Provider Identifier
1053558676
Registry record updated Nov 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
60691 Issued in WI
Practice address
235 E State St
Saint Croix Falls, WI 54024-4117
Phone
(715) 483-3221
Fax
(715) 483-0539
NPI assigned
Jan 20, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 57587 MN
Sleep Medicine (Internal Medicine) Physician 207RS0012X 60691 WI
Pulmonary Disease Physician 207RP1001X 60691 WI Primary

Addresses

Primary practice location

235 E State St
Saint Croix Falls, WI 54024-4117

Mailing address

235 E State St
Saint Croix Falls, WI 54024-4117
Phone (715) 483-3221

Other practice location 1

927 Churchill St W
Stillwater, MN 55082-6605
Phone (651) 439-1234

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mkhan266739@excellian.direct.allina.com Direct St. Croix Regional Medical Center

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20140606001603 MN Practitioner - Pulmonary DiseasePractitioner - Other (Physician)Practitioner - Sleep Medicine 7618191958 Reassigns benefits to 1 organization
I20140609000304 WI Practitioner - Pulmonary Disease 7618191958 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Sleep Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Croix Regional Medical CenterGroup PAC ID 9335032184, 131 clinicians

Practice addresses (Care Compare)

12375 Lindstrom LN
Lindstrom, MN 55045-9551
Phone (651) 400-2240

235 E State St
St Croix Falls, WI 54024-4117

235 State St
St Croix Falls, WI 54024-4117

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60691WIMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Burnett Medical Center Inc Current Accepting new patients
St. Croix Regional Medical Center CurrentSince Jul 1, 2014 Accepting new patients
Burnett Medical Center Inc CurrentSince Oct 1, 2015 Accepting new patients
St. Croix Regional Medical Center CurrentSince Jul 1, 2014 Accepting new patients
Burnett Medical Center Inc CurrentSince Oct 1, 2015 Accepting new patients

Locations

257 W Saint George Ave
Grantsburg, WI 54840
Phone (715) 463-5353

216 S Adams St
St Croix Fls, WI 54024
Phone (715) 483-0426

235 E State St
St Croix Fls, WI 54024
Phone (715) 483-3221

Interoperability endpoints

  • Direct secure messaging: mkhan266739@excellian.direct.allina.com

Organizations & group practices 5

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.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1232409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1053558676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 E STATE ST",
            "city": "SAINT CROIX FALLS",
            "state": "WI",
            "postal_code": "540244117",
            "telephone_number": "715-483-3221",
            "fax_number": "715-483-0539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 E STATE ST",
            "city": "SAINT CROIX FALLS",
            "state": "WI",
            "postal_code": "540244117",
            "telephone_number": "715-483-3221",
            "fax_number": "715-483-0539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "927 Churchill St W",
            "address_purpose": "LOCATION",
            "city": "Stillwater",
            "state": "MN",
            "postal_code": "550826605",
            "country_code": "US",
            "telephone_number": "651-439-1234",
            "fax_number": "651-275-3325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MUHAMMAD",
        "middle_name": "TALHA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-20",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MN",
            "license": "57587",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "WI",
            "license": "60691",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WI",
            "license": "60691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkhan266739@excellian.direct.allina.com",
            "affiliation": "Y",
            "affiliationName": "St. Croix Regional Medical Center",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "235 E State St",
            "city": "Saint Croix Falls",
            "state": "WI",
            "country_code": "US",
            "postal_code": "540244117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Croix Falls, WI

Sources for this page

Verify at the official NPI Registry.