Active NPI
Mohammad Mushtaq Khan, M.D.
- Cardiovascular Disease Physician
- Yuma, AZ
National Provider Identifier
1104841147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 13786
- Practice address
- 1025 W 24TH St
Suite #27
Yuma, AZ 85364-8366 - Phone
- (928) 344-9000
- Fax
- (928) 344-9002
- NPI assigned
- Jul 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 13786 | AZ | Primary |
Addresses
Primary practice location
1025 W 24TH St
Suite #27
Yuma, AZ 85364-8366
Mailing address
1025 W 24TH St
Suite #27
Yuma, AZ 85364-8366
Phone (928) 344-9000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 222860 | Other | AZ | AHCCCS |
| AZ0387310 | Other | AZ | BLUECROSS BLUESHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104841147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 W 24TH ST",
"address_2": "SUITE #27",
"city": "YUMA",
"state": "AZ",
"postal_code": "853648366",
"telephone_number": "928-344-9000",
"fax_number": "928-344-9002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 W 24TH ST",
"address_2": "SUITE #27",
"city": "YUMA",
"state": "AZ",
"postal_code": "853648366",
"telephone_number": "928-344-9000",
"fax_number": "928-344-9002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "MOHAMMAD",
"middle_name": "MUSHTAQ",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "AZ",
"license": "13786",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AHCCCS",
"identifier": "222860",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "AZ0387310",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yuma, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.