NPIMap

Individual provider Active NPI

Shah-Naz H Khan, MD

  • Neurological Surgery Physician
  • Flint, MI
National Provider Identifier
1063615904
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
4301062181 Issued in MI
Practice address
1020 Charter Dr Ste C
Flint, MI 48532-3584
Phone
(810) 212-4100
Fax
(810) 250-4514
NPI assigned
Jun 7, 2007
Last updated
May 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 4301062181 MI Primary
Neurological Surgery Physician 207T00000X 40672 OK

Addresses

Primary practice location

1020 Charter Dr Ste C
Flint, MI 48532-3584

Mailing address

1020 Charter Dr Ste C
Flint, MI 48532-3584
Phone (810) 212-4100

Other practice location 1

6475 S Yale Ave Ste 308
Tulsa, OK 74136-7802
Phone (918) 499-4000

Other practice location 2

1 Hurley Plz # 7W
Flint, MI 48503-5902
Phone (810) 262-9355

Other identifiers 1

IdentifierTypeStateIssuer
1063615904MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, MI, OK3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20090630000328 MO Practitioner - Neurosurgery 1254499809 Reassigns benefits to 2 organizations
I20140529000839 MI Practitioner - Neurosurgery 1254499809 Reassigns benefits to 4 organizations
I20230320002965 OK Practitioner - Neurosurgery 1254499809 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians
Ascension Medical Group PromedGroup PAC ID 7315856077, 255 clinicians
Warren Clinic IncGroup PAC ID 8820900293, 787 clinicians

Practice addresses (Care Compare)

1187 W Bristol Rd
Suite 1
Flint, MI 48507-5559
Phone (810) 212-4100

1229 E Seminole St
Springfield, MO 65804-2227
Phone (417) 820-5150

1541 Gull Rd
Kalamazoo, MI 49048-1644
Phone (269) 381-7380

6161 S Yale Ave
Tulsa, OK 74136-1902
Phone (918) 502-4720

6600 S Yale Ave
Suite 1400
Tulsa, OK 74136-3331
Phone (918) 488-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40672OKMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Apr 12, 2024 Accepting new patients
Warren Clinic Inc CurrentSince May 1, 2023 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Apr 12, 2024 Accepting new patients
McLaren Northern Michigan CurrentSince Jul 15, 2024 Accepting new patients
Institute of General and Endovascular Neurosurgery Neurological Surgery CurrentSince Nov 29, 2014 Accepting new patients
Promed Healthcare CurrentSince Dec 24, 2021 Accepting new patients
Beacon Medical Group Michigan Inc Current Accepting new patients
Hurley Medical Center CurrentSince Aug 16, 2014 Accepting new patients
Hurley Medical Center CurrentSince Aug 16, 2014 Accepting new patients
Beacon Medical Group Michigan Inc CurrentSince Dec 24, 2021 Accepting new patients
McLaren Northern Michigan CurrentSince Jul 15, 2024 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Apr 12, 2024 Accepting new patients
Hurley Medical Center Current Accepting new patients
Igen on Call PLLC Neurological Surgery Past Accepting new patients
St. Francis Orthopaedic Institute LLC Past Accepting new patients

Locations

1 Hurley Plz
Flint, MI 48503
Phone (810) 257-9000

1 Hurley Plz
#7W
Flint, MI 48503
Phone (810) 262-9355

1020 Charter Dr
Ste C
Flint, MI 48532
Phone (810) 212-4100

1187 W Bristol Rd
Ste 1
Flint, MI 48507
Phone (810) 212-4100

1295 S Linden Rd
Ste A
Flint, MI 48532
Phone (810) 212-4100

1541 Gull Rd
Kalamazoo, MI 49048
Phone (269) 343-1264

215 E Mansion St
Marshall, MI 49068
Phone (269) 789-8120

2390 Mitchell Park Dr
Ste D
Petoskey, MI 49770
Phone (231) 242-1760

416 Connable Ave
Petoskey, MI 49770
Phone (231) 487-4000

7901 Angling Rd
Portage, MI 49024
Phone (269) 324-8405

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

6600 S Yale Ave
Ste 1200
Tulsa, OK 74136
Phone (918) 488-6045

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

Interoperability endpoints

  • Direct secure messaging: skhan1134610@direct.hfhs.org

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 15

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1063615904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 CHARTER DR STE C",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323584",
            "telephone_number": "810-212-4100",
            "fax_number": "810-250-4514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 CHARTER DR STE C",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323584",
            "telephone_number": "810-212-4100",
            "fax_number": "810-250-4514"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6475 S Yale Ave Ste 308",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741367802",
            "country_code": "US",
            "telephone_number": "918-499-4000",
            "fax_number": "918-499-4001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Hurley Plz # 7W",
            "address_purpose": "LOCATION",
            "city": "Flint",
            "state": "MI",
            "postal_code": "485035902",
            "country_code": "US",
            "telephone_number": "810-262-9355",
            "fax_number": "810-262-6341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SHAH-NAZ",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MI",
            "license": "4301062181",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "OK",
            "license": "40672",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063615904",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.