Atif Khan, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

243890 Issued in MA

Practice address

131 Old Road Nine Acre Corner
JCB Suite 500
Concord, MA 01742

Phone

(978) 287-3547

Fax

(978) 287-2949

NPI assigned

Jun 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 14

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

General Surgery

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emerson Practice Associates, IncGroup PAC ID 8123188117, 247 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Emerson Hospital - Hospital, W Concord, MA, CCN 220084

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: khan.atif.epa@direct.partners.masshiway.net

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.

• Emerson Practice Associates, Inc.

  • Internal Medicine Physician
  • Concord, MA
  • NPI 1508020199
  Medicare reassignment Care Compare group NPD

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

• Emerson Hospital

  • General Acute Care Hospital
  • Concord, MA
  • NPI 1922103357
  Care Compare affiliation

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1063417145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 OLD ROAD NINE ACRE CORNER",
            "address_2": "JCB SUITE 500",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "01742",
            "telephone_number": "978-287-3547",
            "fax_number": "978-287-2949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 OLD ROAD NINE ACRE CORNER",
            "address_2": "JCB SUITE 500",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "01742",
            "telephone_number": "978-287-3547",
            "fax_number": "978-287-2949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "ATIF",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "243890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LUNG",
            "identifier": "200026",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV WORKERS COMPENSATION",
            "identifier": "54183971800",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5727853",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200212000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "236802",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS MOUNTAIN STATE",
            "identifier": "541839718105",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCN",
            "identifier": "5400143",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007312997",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARELINK",
            "identifier": "188426",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "245780",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS MOUNTAIN STATE",
            "identifier": "541839718101",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7646497",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "188426",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "C&O",
            "identifier": "541839718",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheila F Kennedy, M.D.
• Kristen Kenney
• Lesley Kenney, NP
• Regan Kerr, LCSW
• Ayesha Naz Khalid, M.D.
• Tanya Khan
• Vannary Khim, MS, RN, FNP-C
• Anne Khudari, LICSW
• Kay L Kim, M.D.
• Shahawna Lee Kim, PSYD

• Surgery Physician in Concord, MA
• Providers in Concord, MA by specialty
• Surgery Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.