NPIMap

Individual provider Active NPI

Shujauddin Khan, M.D.

  • General Practice Physician
  • Sandston, VA
National Provider Identifier
1114126067
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
0101053528 Issued in VA
Practice address
35 E Williamsburg Rd
Sandston, VA 23150-2011
Phone
(804) 737-7804
NPI assigned
Jul 12, 2007
Last updated
Sep 16, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 0101053528 VA Primary

Addresses

Primary practice location

35 E Williamsburg Rd
Sandston, VA 23150-2011

Mailing address

35 E Williamsburg Rd
Sandston, VA 23150-2011
Phone (804) 737-7804

Other practice location 1

8110 Midlothian Tpke
North Chesterfield, VA 23235-5116
Phone (804) 320-8160

Other identifiers 3

IdentifierTypeStateIssuer
454249OtherVAANTHEM BCBS
005877814MedicaidVA
705067OtherVAAETNA

Other names 1

  • Shuja U Khan Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100806000151 VA Practitioner - Internal Medicine 5395770150 Reassigns benefits to 2 organizations
I20160714000128 DC Practitioner - Internal Medicine 5395770150 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

35 E Williamsburg Rd
Sandston, VA 23150-2011
Phone (804) 737-7804

601 Potomac Station Dr
Leesburg, VA 20176-1816
Phone (703) 840-1396

8110 Midlothian Tpke
North Chesterfield, VA 23235-5116
Phone (804) 320-8160

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101053528VAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Patient First Richmond Medical Group PLLC CurrentSince Jul 1, 2016 Accepting new patients
Patient First Richmond Medical Group PLLC CurrentSince Jul 1, 2016 Accepting new patients

Locations

6311 Richmond Hwy
Alexandria, VA 22306
Phone (703) 647-6087

5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355

601 Potomac Station Dr NE
Leesburg, VA 20176
Phone (703) 840-1396

8110 Midlothian Tpke
North Chesterfield, VA 23235
Phone (804) 320-8160

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1184198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1114126067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 E WILLIAMSBURG RD",
            "city": "SANDSTON",
            "state": "VA",
            "postal_code": "231502011",
            "telephone_number": "804-737-7804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 E WILLIAMSBURG RD",
            "city": "SANDSTON",
            "state": "VA",
            "postal_code": "231502011",
            "telephone_number": "804-737-7804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8110 Midlothian Tpke",
            "address_purpose": "LOCATION",
            "city": "North Chesterfield",
            "state": "VA",
            "postal_code": "232355116",
            "country_code": "US",
            "telephone_number": "804-320-8160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SHUJAUDDIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-12",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101053528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "454249",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005877814",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "705067",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHUJA",
            "last_name": "KHAN",
            "middle_name": "U",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sandston, VA

Sources for this page

Verify at the official NPI Registry.