Active NPI
Waqqas H Khan, MD
- Anesthesiology Physician
- Belleville, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 036086446
- Practice address
- 211 S 3Rd St
Belleville, IL 62220-1915 - Phone
- (618) 234-2120
- Fax
- (618) 641-5810
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 036086446 | IL | Primary |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 036086446 | IL |
Addresses
Primary practice location
211 S 3Rd St
Belleville, IL 62220-1915
Mailing address
211 S 3Rd St
Belleville, IL 62220-1915
Phone (618) 234-2120
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036086446 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
6742 N Frostwood Pkwy
Peoria, IL 61615-2402
Phone (309) 692-5393
Hospital & facility affiliations
- Saint Francis Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036086446 | IL | MD | Pain Medicine (Anesthesiology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marion Anesthesia Company LLC | Current | Accepting new patients | |
| Associated Anesthesiologists, S.C. | Anesthesiology | Current | Accepting new patients |
| Associated Anesthesiologists, SC | Anesthesiology | Current | Accepting new patients |
| St. Mary'S Hospital, Centralia, Illinois | Current | Accepting new patients | |
| St. Mary'S Hospital, Centralia, Illinois | Current | Accepting new patients | |
| Granite City Physicians Corp | Past | Accepting new patients | |
| Tas of Kentucky LLC | Anesthesiology | Past | Accepting new patients |
Locations
400 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5221
7420 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-3155
3003 Civic Circle Blvd
Marion, IL 62959
Phone (618) 993-1112
6742 N Frostwood Pkwy
Peoria, IL 61615
Phone (309) 692-5393
530neglen Oak Ave
Peoria, IL 61637
Phone (309) 692-5393
Organizations & group practices 8
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.
-
- Anesthesiology Physician
- Peoria, IL
- NPI 1558306480
-
- Certified Registered Nurse Anesthetist
- Marion, IL
- NPI 1790721579
-
- Emergency Medicine Physician
- Centralia, IL
- NPI 1770687196
-
- Certified Registered Nurse Anesthetist
- Metropolis, IL
- NPI 1548636418
-
- Anesthesiology Physician
- Peoria, IL
- NPI 1023612082
-
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Centralia, IL
- NPI 1710105192
-
- Clinical Medical Laboratory
- Granite City, IL
- NPI 1508983214
-
- Anesthesiology Physician
- Mayfield, KY
- NPI 1255735346
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299715200000",
"number": "1083620140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 S 3RD ST",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622201915",
"telephone_number": "618-234-2120",
"fax_number": "618-641-5810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 S 3RD ST",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622201915",
"telephone_number": "618-234-2120",
"fax_number": "618-641-5810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "WAQQAS",
"middle_name": "H",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2011-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IL",
"license": "036086446",
"primary": true
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "IL",
"license": "036086446",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036086446",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Belleville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2011; 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.