NPIMap

Individual provider Active NPI

John N Khalifa, MD

  • Family Medicine Physician
  • Exton, PA
National Provider Identifier
1134190341
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD420093 Issued in PA
Practice address
93 W Devon Dr
Suite 100
Exton, PA 19341-3062
Phone
(610) 321-0200
Fax
(610) 594-2625
NPI assigned
Jan 27, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD420093 PA Primary

Addresses

Primary practice location

93 W Devon Dr
Suite 100
Exton, PA 19341-3062

Mailing address

412 Creamery Way
Suite 400
Exton, PA 19341-2551
Phone (610) 594-7590

Other identifiers 1

IdentifierTypeStateIssuer
001967317MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20080512000310 PA Practitioner - Family Practice 3375622616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
H2 Rehabilitation Extension Services LLCGroup PAC ID 6406131622, shared by 5 NPIs, 161 clinicians
Pentahealth, LLCGroup PAC ID 9537586672, 67 clinicians

Practice addresses (Care Compare)

137 Montgomery Ave
Suite 205
Boyertown, PA 19512-1300
Phone (484) 658-3150

93 W Devon Dr
100 Gateway Medical Associates PC
Exton, PA 19341-3008
Phone (610) 321-0200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pentahealth, LLC Family Medicine CurrentSince Oct 1, 2020 Accepting new patients
Gateway Medical Specialists, LLC PastSince Jan 1, 2018 Accepting new patients
Main Line Healthcare Family Medicine PastSince Oct 1, 2002 Accepting new patients

Locations

412 Creamery Way
Ste 400
Exton, PA 19341
Phone (610) 269-9448

93 W Devon Dr
Ste 100
Exton, PA 19341
Phone (610) 321-0200

520 Maple Ave
Ste 4
West Chester, PA 19380
Phone (610) 430-8200

Interoperability endpoints

  • Direct secure messaging: johnkhalifa@gmacc.allscriptsdirect.net

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 11

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": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1134190341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 CREAMERY WAY",
            "address_2": "SUITE 400",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193412551",
            "telephone_number": "610-594-7590",
            "fax_number": "610-594-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 W DEVON DR",
            "address_2": "SUITE 100",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193413062",
            "telephone_number": "610-321-0200",
            "fax_number": "610-594-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIFA",
        "first_name": "JOHN",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD420093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001967317",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Exton, PA

Sources for this page

Verify at the official NPI Registry.