Individual provider Active NPI

Muneera Khan

  • Physician Assistant
  • Bellingham, WA
National Provider Identifier
1194261271
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61051155 Issued in WA
Practice address
4545 Cordata Pkwy Ste 1D
Bellingham, WA 98226-7264
Phone
(360) 738-2200
NPI assigned
Jan 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA61051155 WA Primary

Addresses

Primary practice location

4545 Cordata Pkwy Ste 1D
Bellingham, WA 98226-7264

Mailing address

100 High St
Buffalo, NY 14203-1126

Other practice location 1

2000 Hospital Dr
Sedro Woolley, WA 98284-4327
Phone (360) 856-7588

Other practice location 2

1990 Hospital Dr Ste 100
Sedro Woolley, WA 98284-9315
Phone (360) 856-8800

Other practice location 3

2901 Squalicum Pkwy
Bellingham, WA 98225-1851
Phone (360) 752-5216

Other practice location 4

1117 Spring St
Friday Harbor, WA 98250-9782
Phone (360) 378-1738

Other practice location 5

100 High St
Buffalo, NY 14203-1126
Phone (716) 859-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170223000572 NY Practitioner - Physician Assistant 9537443379 Reassigns benefits to 1 organization
I20211214002106 WA Practitioner - Physician Assistant 9537443379 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
PeacehealthGroup PAC ID 9537073960, 292 clinicians

Practice addresses (Care Compare)

3015 Squalicum Pkwy
Bellingham, WA 98225-1906

Hospital & facility affiliations

  • Peacehealth St Joseph Medical Center Hospital, Bellingham, WA, CCN 500030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA61051155WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kaleida Health CurrentSince Feb 15, 2018 Accepting new patients
University at Buffalo Pathologists, Inc Current Accepting new patients
Peacehealth CurrentSince Jul 20, 2022 Accepting new patients
Kaleida Health CurrentSince Feb 15, 2018 Accepting new patients
Peacehealth Past Accepting new patients

Locations

100 High St
#13282
Buffalo, NY 14203

100 High St
Buffalo, NY 14203
Phone (716) 632-3700

445 Tremont St
North Tonawanda, NY 14120
Phone (716) 690-2291

1117 Spring St
Friday Harbor, WA 98250
Phone (360) 378-1738

Interoperability endpoints

  • Direct secure messaging: mkhan540911@direct.peacehealth.org

Organizations & group practices 10

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 3

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": "1484179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1194261271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HIGH ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 CORDATA PKWY STE 1D",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982267264",
            "telephone_number": "360-738-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2000 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Sedro Woolley",
            "state": "WA",
            "postal_code": "982844327",
            "country_code": "US",
            "telephone_number": "360-856-7588",
            "fax_number": "360-866-7252",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1990 Hospital Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Sedro Woolley",
            "state": "WA",
            "postal_code": "982849315",
            "country_code": "US",
            "telephone_number": "360-856-8800",
            "fax_number": "360-714-2522",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2901 Squalicum Pkwy",
            "address_purpose": "LOCATION",
            "city": "Bellingham",
            "state": "WA",
            "postal_code": "982251851",
            "country_code": "US",
            "telephone_number": "360-752-5216",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1117 Spring St",
            "address_purpose": "LOCATION",
            "city": "Friday Harbor",
            "state": "WA",
            "postal_code": "982509782",
            "country_code": "US",
            "telephone_number": "360-378-1738",
            "fax_number": "360-378-1784",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 High St",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142031126",
            "country_code": "US",
            "telephone_number": "716-859-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MUNEERA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-12",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61051155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.