Individual provider Active NPI

Shahbaz Amir Khan, MBBS

  • Child & Adolescent Psychiatry Physician
  • Washington, DC
National Provider Identifier
1164597167
Registry record updated Mar 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
MD045835 Issued in DC
Practice address
4228 Wisconsin Ave NW
Washington, DC 20016-2138
Phone
(202) 885-5600
NPI assigned
Nov 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A100500 CA
Child & Adolescent Psychiatry Physician 2084P0804X MD045835 DC Primary

Addresses

Primary practice location

4228 Wisconsin Ave NW
Washington, DC 20016-2138

Mailing address

4228 Wisconsin Ave NW
Washington, DC 20016-2138
Phone (202) 885-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20180627000247 DC Practitioner - Psychiatry 2567554025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wisconsin Ave Psychiatric Center IncGroup PAC ID 5991791162, 9 clinicians

Practice addresses (Care Compare)

4228 Wisconsin Ave NW
Psychiatric Institute of Washington
Washington, DC 20016-2138
Phone (202) 965-8550

Merit-based Incentive Payment System (MIPS)

Final score
89.92 of 100Reported as group
Quality
75.35
Improvement activities
40
Cost
89.52

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wisconsin Ave Psychiatric Center Inc Psychiatry CurrentSince Apr 9, 2018 Accepting new patients
Faith Regional Physician Services, LLC Psychiatry PastSince Dec 28, 2015 Accepting new patients
Faith Regional Physician Services, LLC Past Accepting new patients

Locations

4228 Wisconsin Ave NW
Washington, DC 20016
Phone (202) 885-5600

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.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647043200000",
    "number": "1164597167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4228 WISCONSIN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200162138",
            "telephone_number": "202-885-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4228 WISCONSIN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200162138",
            "telephone_number": "202-885-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SHAHBAZ",
        "middle_name": "AMIR",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2022-03-12",
        "certification_date": "2022-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A100500",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "DC",
            "license": "MD045835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.