NPIMap

Individual provider Active NPI

Wajahat A Khan, MD

  • Medical Oncology Physician
  • Grosse Pointe Woods, MI
National Provider Identifier
1144234782
Registry record updated Aug 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
WK066812 Issued in MI
Practice address
19229 Mack Ave Ste 24
Grosse Pointe Woods, MI 48236-2857
Phone
(313) 884-5522
Fax
(313) 884-5521
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X WK066812 MI Primary

Addresses

Primary practice location

19229 Mack Ave Ste 24
Grosse Pointe Woods, MI 48236-2857

Mailing address

19229 Mack Ave Ste 24
Grosse Pointe Woods, MI 48236-2857
Phone (313) 884-5522

Other identifiers 3

IdentifierTypeStateIssuer
4622804MedicaidMI
4622690MedicaidMI
0824295OtherMIBCN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20040909000232 MI Practitioner - Medical Oncology 8921074030 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

17900 23 Mile Rd
Macomb, MI 48044-1161

1901 Star Batt Dr
Rochester Hills, MI 48309-3767
Phone (248) 844-4000

22101 Moross Rd
Detroit, MI 48236-2148
Phone (586) 753-0011

4014 River Rd
Suite 1
East China, MI 48054-2916
Phone (810) 326-1229

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as apm

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
WK066812MIMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Semi Medical Group Medical Oncology CurrentSince Oct 1, 2014 Accepting new patients
Henry Ford Semi Medical Group CurrentSince Oct 1, 2014 Accepting new patients
Pathology Specialists of Southeast Michigan PC Current Accepting new patients
Henry Ford Health St. John Hospital Current Accepting new patients
St. John Hospital Past Accepting new patients

Locations

22101 Moross Rd
Detroit, MI 48236
Phone (313) 343-3248

22201 Moross Rd
Ste 214
Detroit, MI 48236
Phone (313) 343-7110

37771 Schoenherr Rd
Ste 104
Sterling Hts, MI 48312
Phone (810) 286-0050

30117 Schoenherr Rd
Ste 400
Warren, MI 48088
Phone (586) 552-4848

11800 E 12 Mile Rd
Warren, MI 48093
Phone (586) 573-5000

Interoperability endpoints

  • Direct secure messaging: wkhan63460@direct.hfhs.org

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 6

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440547200000",
    "number": "1144234782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19229 MACK AVE STE 24",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362857",
            "telephone_number": "313-884-5522",
            "fax_number": "313-884-5521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19229 MACK AVE STE 24",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482362857",
            "telephone_number": "313-884-5522",
            "fax_number": "313-884-5521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "WAJAHAT",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2015-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MI",
            "license": "WK066812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4622804",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4622690",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "0824295",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Woods, MI

Sources for this page

Verify at the official NPI Registry.