NPIMap

Individual provider Active NPI

Mustafa Khan, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Milwaukee, WI
National Provider Identifier
1104873652
Registry record updated Oct 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
35.096184 Issued in OH
Practice address
1218 W Kilbourn Ave Ste 301
Milwaukee, WI 53233-1325
Phone
(414) 276-6000
Fax
(414) 276-1758
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 35.096184 OH Primary

Addresses

Primary practice location

1218 W Kilbourn Ave Ste 301
Milwaukee, WI 53233-1325

Mailing address

1218 W Kilbourn Ave Ste 301
Milwaukee, WI 53233-1325
Phone (414) 276-6000

Other identifiers 1

IdentifierTypeStateIssuer
2746863MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20171106000749 WI Practitioner - Orthopedic Surgery 7315959475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Perelman School of Med at the University of Pennsylvania, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Milwaukee Orthopaedic Group LTDGroup PAC ID 2769466036, 10 clinicians
Advantage Physical Therapy and Sports Rehab, LLCGroup PAC ID 8022016336, shared by 3 NPIs, 289 clinicians

Practice addresses (Care Compare)

1218 W Kilbourn Ave
Milwaukee, WI 53233-1330
Phone (414) 276-6000

7200 Washington Ave
Mount Pleasant, WI 53406-6516
Phone (262) 583-0790

Hospital & facility affiliations

  • Froedtert Memorial Lutheran Hospital Hospital, Milwaukee, WI, CCN 520177
  • Aurora St Lukes Medical Center Hospital, Milwaukee, WI, CCN 520138
  • Aurora Medical Center Hospital, Grafton, WI, CCN 520207
  • Orthopaedic Hospital of Wisconsin Hospital, Glendale, WI, CCN 520194

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion31
Laminectomy or laminotomy (partial removal of spine bones)21

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Milwaukee Orthopaedic Group LTD Orthopaedic Surgery of the Spine CurrentSince Oct 2, 2017 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
South Jersey Center for Orthopedics & Sports Medicine Past Accepting new patients
Milwaukee Orthpaedic Group LTD Past Accepting new patients
Silver Orthopaedics PA Past Accepting new patients

Locations

10586 N Port Washington Rd
Mequon, WI 53092
Phone (262) 243-9100

1218 W Kilbourn Ave
Milwaukee, WI 53233
Phone (414) 219-7343

1218 W Kilbourn Ave
Ste 301
Milwaukee, WI 53233
Phone (414) 276-6000

Organizations & group practices 5

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 5

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": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507680000000",
    "number": "1104873652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 W KILBOURN AVE STE 301",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331325",
            "telephone_number": "414-276-6000",
            "fax_number": "414-276-1758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 W KILBOURN AVE STE 301",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331325",
            "telephone_number": "414-276-6000",
            "fax_number": "414-276-1758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MUSTAFA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2017-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "OH",
            "license": "35.096184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2746863",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.