Individual provider Active NPI

Shahid A Khan, MD

  • Internal Medicine Physician
  • East Greenwich, RI
National Provider Identifier
1104907625
Registry record updated Feb 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD10893 Issued in RI
Practice address
1351 S County TRL
Suite 215
East Greenwich, RI 02818-5079
Phone
(401) 886-9700
Fax
(401) 884-4235
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD10893 RI Primary

Addresses

Primary practice location

1351 S County TRL
Suite 215
East Greenwich, RI 02818-5079

Mailing address

1351 S County TRL
Suite 215
East Greenwich, RI 02818-5079
Phone (401) 886-9700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20040220001062 RI Practitioner - Internal Medicine 9931007101 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1350 Division Rd
Suite 203
West Warwick, RI 02893-7554
Phone (401) 886-9700

Hospital & facility affiliations

  • Elara Caring Home health agency, Warwick, RI, CCN 417035
  • Kent County Memorial Hospital Hospital, Warwick, RI, CCN 410009
  • The Miriam Hospital Hospital, Providence, RI, CCN 410012

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD10893RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Greenwich Medical Associates Inc Internal Medicine CurrentSince Sep 1, 2014 Accepting new patients

Locations

1351 S County Trl
Ste 215
East Greenwich, RI 02818
Phone (401) 886-0890

1350 Division Rd
Ste 203
West Warwick, RI 02893
Phone (401) 886-9700

Interoperability endpoints

  • Direct secure messaging: skhan@kent.cernerdirect.carene.org
  • Direct secure messaging: skhan@direct.carene.org

Organizations & group practices 1

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202860800000",
    "number": "1104907625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 S COUNTY TRL",
            "address_2": "SUITE 215",
            "city": "EAST GREENWICH",
            "state": "RI",
            "postal_code": "028185079",
            "telephone_number": "401-886-9700",
            "fax_number": "401-884-4235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 S COUNTY TRL",
            "address_2": "SUITE 215",
            "city": "EAST GREENWICH",
            "state": "RI",
            "postal_code": "028185079",
            "telephone_number": "401-886-9700",
            "fax_number": "401-884-4235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SHAHID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2008-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD10893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Greenwich, RI

Sources for this page

Verify at the official NPI Registry.