Individual provider Active NPI

Muhammad Osman Salim Khan

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Gilbert, AZ
National Provider Identifier
1124409073
Registry record updated Aug 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X
License
5101021981 Issued in MI
Practice address
3507 S Mercy Rd Ste 101
Gilbert, AZ 85297-0441
Phone
(480) 926-0644
Fax
(480) 926-0645
NPI assigned
Jun 17, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Neuromusculoskeletal Medicine) Physician 204C00000X 5101021981 MI Primary

Addresses

Primary practice location

3507 S Mercy Rd Ste 101
Gilbert, AZ 85297-0441

Mailing address

3507 S Mercy Rd
Ste 101
Gilbert, AZ 85297-0441
Phone (480) 926-0644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20200630000839 AZ Practitioner - Neurology 8921420498 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Arizona College of Osteopathic Medicine Mid Western University, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foothills Neurology P CGroup PAC ID 6507757234, 24 clinicians

Practice addresses (Care Compare)

4530 E Muirwood Dr
Suite 111
Phoenix, AZ 85048-7693
Phone (480) 961-2365

Hospital & facility affiliations

  • Mercy Gilbert Medical Center Hospital, Gilbert, AZ, CCN 030119
  • Chandler Regional Medical Center Hospital, Chandler, AZ, CCN 030036

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5101021981MIMDSports Medicine (Neuromusculoskeletal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neurosin PLLC CurrentSince Jun 28, 2020 Accepting new patients
Foothills Neurology P C Neurology CurrentSince Jan 18, 2025 Accepting new patients
Gilbert Neurology Partners PLLC Neurology CurrentSince Aug 1, 2020 Accepting new patients

Locations

3507 S Mercy Rd
Gilbert, AZ 85297

3507 S Mercy Rd
Ste 101
Gilbert, AZ 85297
Phone (480) 926-0644

3555 S Val Vista Dr
Gilbert, AZ 85297
Phone (480) 434-4356

4530 E Muirwood Dr
Ste 111
Phoenix, AZ 85048
Phone (480) 551-5469

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596931200000",
    "number": "1124409073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3507 S MERCY RD",
            "address_2": "STE 101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852970441",
            "telephone_number": "480-926-0644",
            "fax_number": "480-926-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3507 S MERCY RD STE 101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852970441",
            "telephone_number": "480-926-0644",
            "fax_number": "480-926-0645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALIM KHAN",
        "first_name": "MUHAMMAD",
        "middle_name": "OSMAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-17",
        "last_updated": "2020-08-09",
        "certification_date": "2020-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "MI",
            "license": "5101021981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.