Active NPI
Abdul M Khadra, M.D.
- Internal Medicine Physician
- West Springfield, MA
National Provider Identifier
1194778159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 37593
- Practice address
- 954 Westfield St
West Springfield, MA 01089-3809 - Phone
- (413) 733-2127
- Fax
- (413) 733-2128
- NPI assigned
- May 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 37593 | MA | Primary |
| Interventional Cardiology Physician | 207RI0011X | 37593 | MA |
Addresses
Primary practice location
954 Westfield St
West Springfield, MA 01089-3809
Mailing address
954 Westfield St
West Springfield, MA 01089-3809
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 037593 | Other | MA | TUFTS |
| 13575 | Other | MA | HEALTH NEW ENGLAND |
| 3002233 | Medicaid | MA | |
| H22028 | Other | MA | BCBS |
| 798624 | Other | MA | CONNECTICARE |
| 037593 | Other | MA | SECURE HORIZONS |
| 100064 | Other | MA | CIGNA |
| 566945 | Other | MA | US HEALTHCARE |
| 4411111942 | Other | MA | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050520000380 | MA | Practitioner - Cardiovascular Disease (Cardiology) | 6204877160 | Practice locations: West Springfield, MA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37593 | MA | MD | Interventional Cardiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218499200000",
"number": "1194778159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "954 WESTFIELD ST",
"city": "WEST SPRINGFIELD",
"state": "MA",
"postal_code": "010893809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "954 WESTFIELD ST",
"city": "WEST SPRINGFIELD",
"state": "MA",
"postal_code": "010893809",
"telephone_number": "413-733-2127",
"fax_number": "413-733-2128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHADRA",
"first_name": "ABDUL",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-18",
"last_updated": "2008-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "37593",
"primary": true
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "MA",
"license": "37593",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "037593",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NEW ENGLAND",
"identifier": "13575",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3002233",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "H22028",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICARE",
"identifier": "798624",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SECURE HORIZONS",
"identifier": "037593",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "100064",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US HEALTHCARE",
"identifier": "566945",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "4411111942",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Springfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.