Individual provider Active NPI

Amanulla Khaji

  • Hospitalist Physician
  • Wynnewood, PA
National Provider Identifier
1083940985
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD443150 Issued in PA
Practice address
100 E Lancaster Ave
4 Pavilion, Suite 4303
Wynnewood, PA 19096-3450
Phone
(484) 476-6421
Fax
(484) 476-3149
NPI assigned
Oct 27, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD443150 PA
Hospitalist Physician 208M00000X MD443150 PA Primary

Addresses

Primary practice location

100 E Lancaster Ave
4 Pavilion, Suite 4303
Wynnewood, PA 19096-3450

Mailing address

100 E Lancaster Ave
4 Pavilion, Suite 4303
Wynnewood, PA 19096-3450
Phone (484) 476-6421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20110715000514 PA Practitioner - HospitalistPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 8224206354 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hammad Raza PCGroup PAC ID 9537427745, 7 clinicians
West Chester Cardiology,PCGroup PAC ID 2567376916, 4 clinicians

Practice addresses (Care Compare)

1930 S Broad St
Philadelphia, PA 19145-2328
Phone (484) 342-4153

531 Maple Ave
West Chester, PA 19380-4416
Phone (610) 692-4382

Hospital & facility affiliations

  • Chester County Hospital Hospital, West Chester, PA, CCN 390179
  • Paoli Hospital Hospital, Paoli, PA, CCN 390153
  • Hospital of Univ of Pennsylvania Hospital, Philadelphia, PA, CCN 390111

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair36

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Hammad Raza PC Hospitalist CurrentSince Jan 17, 2023 Accepting new patients
Brandywine Internal Medicine, LLC Internal Medicine PastSince Jul 10, 2019 Accepting new patients

Locations

1930 S Broad St
Philadelphia, PA 19145
Phone (215) 339-4563

Organizations & group practices 3

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1256601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493596800000",
    "number": "1083940985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "4 PAVILION, SUITE 4303",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "484-476-6421",
            "fax_number": "484-476-3149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "4 PAVILION, SUITE 4303",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "484-476-6421",
            "fax_number": "484-476-3149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAJI",
        "first_name": "AMANULLA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-27",
        "last_updated": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD443150",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD443150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wynnewood, PA

Sources for this page

Verify at the official NPI Registry.