NPIMap

Individual provider Active NPI

Youssef Khawaja, MD

  • Internal Medicine Physician
  • Plantsville, CT
National Provider Identifier
1184603631
Registry record updated Oct 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
033533 Issued in CT
Practice address
16 Cornerstone CT
Plantsville, CT 06479-1551
Phone
(860) 621-9353
Fax
(860) 621-1815
NPI assigned
Jan 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 033533 CT
Internal Medicine Physician 207R00000X 033533 CT Primary

Addresses

Primary practice location

16 Cornerstone CT
Plantsville, CT 06479-1551

Mailing address

16 Cornerstone CT
Plantsville, CT 06479-1551
Phone (860) 621-9353

Other identifiers 1

IdentifierTypeStateIssuer
001335331MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20060301000695 CT Practitioner - Internal MedicinePractitioner - Endocrinology 8224044193 Reassigns benefits to 1 organization
Practice locations: Plantsville, CT

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Endocrinology
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16 Cornerstone CT
Plantsville, CT 06479-1551

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
033533CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Hospital of Central Connecticut at New Britain General and Bradley Internal Medicine Current Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Mar 1, 2006 Accepting new patients
The Hospital of Central Connecticut at New Britain General and Bradley CurrentSince Mar 1, 2006 Accepting new patients

Locations

100 Grand St
New Britain, CT 06052
Phone (860) 224-5011

81 Meriden Ave
Southington, CT 06489
Phone (860) 224-5540

Interoperability endpoints

  • Direct secure messaging: youssef.khawaja@xdr.hhchealthdirect.org

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 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": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286496000000",
    "number": "1184603631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 CORNERSTONE CT",
            "city": "PLANTSVILLE",
            "state": "CT",
            "postal_code": "064791551",
            "telephone_number": "860-621-9353",
            "fax_number": "860-621-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 CORNERSTONE CT",
            "city": "PLANTSVILLE",
            "state": "CT",
            "postal_code": "064791551",
            "telephone_number": "860-621-9353",
            "fax_number": "860-621-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAWAJA",
        "first_name": "YOUSSEF",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2010-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CT",
            "license": "033533",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "033533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001335331",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantsville, CT

Sources for this page

Verify at the official NPI Registry.