Individual provider Active NPI

George Khachan, M.D.,P.A.

  • Specialist
  • Cumberland, MD
National Provider Identifier
1164454765
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D38971 Issued in MD
Practice address
625 Kent Ave
Suite 301
Cumberland, MD 21502-3794
Phone
(301) 724-1151
Fax
(301) 724-1894
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X D38971 MD Primary

Addresses

Primary practice location

625 Kent Ave
Suite 301
Cumberland, MD 21502-3794

Mailing address

912 Bishop Walsh Rd
Cumberland, MD 21502-1806
Phone (301) 724-1151

Other identifiers 2

IdentifierTypeStateIssuer
069751600MedicaidMD
3810004421MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20120604000214 MD Practitioner - Obstetrics/Gynecology 2062676091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

625 Kent Ave
Cumberland, MD 21502-3794

625 Kent Ave
Suite 301
Cumberland, MD 21502-3754
Phone (301) 724-1151

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D38971MDMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
George Khachan, M.D., P.a. CurrentSince Jan 1, 2003 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

625 Kent Ave
Ste 301
Cumberland, MD 21502
Phone (301) 724-1151

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 4

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164454765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 BISHOP WALSH RD",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215021806",
            "telephone_number": "301-724-1151",
            "fax_number": "301-724-1894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 KENT AVE",
            "address_2": "SUITE 301",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215023794",
            "telephone_number": "301-724-1151",
            "fax_number": "301-724-1894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHACHAN",
        "first_name": "GEORGE",
        "credential": "M.D.,P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D38971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "069751600",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810004421",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, MD

Sources for this page

Verify at the official NPI Registry.