NPIMap

Individual provider Active NPI

Syed Anjum Khan, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Mankato, MN
National Provider Identifier
1093799595
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
45761 Issued in MN
Practice address
1025 Marsh St
Mankato, MN 56001-4752
Phone
(507) 625-4031
NPI assigned
Nov 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 45761 MN Primary

Addresses

Primary practice location

1025 Marsh St
Mankato, MN 56001-4752

Mailing address

1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address skhan90336@ehrdirect.mayoclinicmsg.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050525000785 MN Practitioner - Critical Care (Intensivists)Practitioner - Internal Medicine 8022050475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic Health System-Southwest Minnesota RegionGroup PAC ID 4688585771, 658 clinicians

Practice addresses (Care Compare)

1025 Marsh St
Mankato, MN 56001-4752
Phone (507) 625-4031

Hospital & facility affiliations

  • Mayo Clinic Health System - Mankato Hospital, Mankato, MN, CCN 240093
  • Mayo Clinic Hospital Rochester Hospital, Rochester, MN, CCN 240010
  • Mayo Clinic Health System - Albert Lea and Austin Hospital, Albert Lea, MN, CCN 240043
  • Mayo Clinic Health System - Waseca Hospital, Waseca, MN, CCN 241345

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45761MNMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Jul 1, 2005 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Jul 1, 2005 Accepting new patients

Locations

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

Ownership & related parties

All facility ownership & control disclosures 10

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mayo Clinic Health System-MankatoMankato, MN, CCN 240093 Hospital Corporate Director Jan 1, 2025
Mayo Clinic Health System-Albert Lea and AustinAlbert Lea, MN, CCN 240043 Hospital Corporate Director Jan 1, 2025
Mayo Clinic Health System-Red WingRed Wing, MN, CCN 240018B Hospital Corporate Director Jan 1, 2025
Mayo Clinic Health System-WasecaWaseca, MN, CCN 241345 Hospital Corporate Director Jan 1, 2025
Mayo Clinic Health System-New PragueNew Prague, MN, CCN 241361 Hospital Corporate Director Jan 1, 2025
Mayo Clinic Health System-Cannon FallsCannon Falls, MN, CCN 241346 Hospital Corporate Director Jan 1, 2025
Mayo Clinic Health System-WasecaWaseca, MN, CCN 24Z345 Hospital Corporate Director Jan 1, 2025
Mayo Clinic Health System-New PragueNew Prague, MN, CCN 24Z361 Hospital Corporate Director Jan 1, 2025
Mayo Clinic Health System-Cannon FallsCannon Falls, MN, CCN 24Z346 Hospital Corporate Director Jan 1, 2025
Mayo Clinic Health System-Lake CityLake City, MN, CCN 245218B Skilled nursing facility Managing Control - Governing Body Jan 1, 2025

Owned or controlled facilities with NPI records 10

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1093799595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MARSH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014752",
            "telephone_number": "507-625-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MARSH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014752",
            "telephone_number": "507-625-4031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SYED",
        "middle_name": "ANJUM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MN",
            "license": "45761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skhan90336@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1025 Marsh St",
            "city": "Mankato",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560014752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

Verify at the official NPI Registry.