NPIMap

Individual provider Active NPI

Nabeel Hasan Khan, M.D.

  • Gastroenterology Physician
  • Southaven, MS
National Provider Identifier
1154490282
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD480004 Issued in PA
Practice address
9140 Highway 51 N
Southaven, MS 38671-1233
Phone
(662) 280-8222
Fax
(662) 280-5541
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 13646-R LA
Gastroenterology Physician 207RG0100X MD480004 PA Primary

Addresses

Primary practice location

9140 Highway 51 N
Southaven, MS 38671-1233

Mailing address

1430 Tulane Ave # TW22
New Orleans, LA 70112-2632
Phone (504) 988-2300

Other practice location 1

164 Greenview Drive
Mount Nittany Health Gastroenterology
State College, PA 16803
Phone (814) 278-4631

Other practice location 2

3901 S Atherton St Ste 2
State College, PA 16801-8324
Phone (814) 278-4631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 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
I20231107001125 PA Practitioner - Gastroenterology 4284535188 Reassigns benefits to 4 organizations
I20250319000823 NJ Practitioner - Gastroenterology 4284535188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dubois Regional Medical CenterGroup PAC ID 5890689715, 424 clinicians
Susquehanna Physician ServicesGroup PAC ID 2264336460, 611 clinicians

Practice addresses (Care Compare)

621 S Main St
Penn Highlands Gastroenterology
Du Bois, PA 15801-1413
Phone (814) 371-0600

700 High St
Williamsport, PA 17701-3100
Phone (570) 321-3454

Hospital & facility affiliations

  • Upmc Williamsport Hospital, Williamsport, PA, CCN 390045
  • Penn Highlands Dubois Hospital, Dubois, PA, CCN 390086

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13646-RLAMDGastroenterology Physician
38239TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bergen County Improvement Authority CurrentSince Mar 10, 2025 Accepting new patients
Dubois Regional Medical Center Gastroenterology CurrentSince Aug 22, 2023 Accepting new patients
Mount Nittany Medical Center Health Services Inc CurrentSince Jun 3, 2024 Accepting new patients
Susquehanna Physician Services CurrentSince Jan 30, 2026 Accepting new patients
Bergen County Improvement Authority CurrentSince Mar 10, 2025 Accepting new patients
Trinity Health Mid-Atlantic Medical Group CurrentSince Jan 21, 2024 Accepting new patients
Dubois Regional Medical Center CurrentSince Aug 22, 2023 Accepting new patients
Trinity Health Mid-Atlantic Medical Group Current Accepting new patients
Trinity Health Mid-Atlantic Medical Group CurrentSince Jan 21, 2024 Accepting new patients
Susquehanna Physician Services Gastroenterology CurrentSince Jan 30, 2026 Accepting new patients
Administrators of the Tulane Education Fund PastSince Jul 31, 2023 Accepting new patients
Mount Nittany Medical Center Health Services Inc Past Accepting new patients

Locations

230 E Ridgewood Ave
Paramus, NJ 07652
Phone (201) 225-4700

141 Medical Park Ln
Bellefonte, PA 16823
Phone (814) 355-7322

1501 Lansdowne Ave
Fl 1
Darby, PA 19023
Phone (610) 237-2531

1503 Lansdowne Ave
Ste 3001
Darby, PA 19023
Phone (610) 586-4100

100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040

621 S Main St
Dubois, PA 15801
Phone (814) 299-7520

1201 Langhorne Newtown Rd
Penndel, PA 19047
Phone (215) 710-2100

1850 E Park Ave
Ste 201
State College, PA 16803
Phone (814) 234-8800

164 Greenview Dr
Ste 445
State College, PA 16803
Phone (814) 278-4631

164 Greenview Dr
State College, PA 16803
Phone (814) 237-4321

3901 S Atherton St
Ste 2
State College, PA 16801
Phone (814) 278-4631

3901 S Atherton St
Ste 130
State College, PA 16801

700 High St
#D
Williamsport, PA 17701
Phone (570) 321-3454

1201 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8723

700 High St
Williamsport, PA 17701
Phone (570) 321-1000

Interoperability endpoints

  • Direct secure messaging: nkhan3678620@direct.trinity-health.org

Organizations & group practices 12

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 35

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 35

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1154490282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 TULANE AVE # TW22",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122632",
            "telephone_number": "504-988-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9140 HIGHWAY 51 N",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386711233",
            "telephone_number": "662-280-8222",
            "fax_number": "662-280-5541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "164 Greenview Drive",
            "address_2": "Mount Nittany Health Gastroenterology",
            "address_purpose": "LOCATION",
            "city": "State College",
            "state": "PA",
            "postal_code": "16803",
            "country_code": "US",
            "telephone_number": "814-278-4631",
            "fax_number": "814-278-4685",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3901 S Atherton St Ste 2",
            "address_purpose": "LOCATION",
            "city": "State College",
            "state": "PA",
            "postal_code": "168018324",
            "country_code": "US",
            "telephone_number": "814-278-4631",
            "fax_number": "814-278-4685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "NABEEL",
        "middle_name": "HASAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "LA",
            "license": "13646-R",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PA",
            "license": "MD480004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.