Individual provider Active NPI

Kashiff Khan, M.D.

  • Family Medicine Physician
  • Vancouver, WA
National Provider Identifier
1194989723
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60222427 Issued in WA
Practice address
400 NE Mother Joseph Place
Vancouver, WA 98664-3200
Phone
(360) 514-3727
NPI assigned
Jul 14, 2008
Last updated
Oct 4, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD60222427 WA Primary

Addresses

Primary practice location

400 NE Mother Joseph Place
Vancouver, WA 98664-3200

Mailing address

1224 SW 162ND Ave
Beaverton, OR 97006
Phone (651) 815-1038

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, GA, OR3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20110831000750 WA Practitioner - HospitalistPractitioner - Family Practice 3476742297 Reassigns benefits to 2 organizations
I20210729002882 GA Practitioner - Family Practice 3476742297 Reassigns benefits to 1 organization
I20221201002900 OR Practitioner - Family Practice 3476742297 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

890 Oak St SE
Salem, OR 97301-3905
Phone (800) 813-2000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC Family Medicine Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine Current Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Nov 14, 2022 Accepting new patients
South Sound Inpatient Physicians PLLC Family Medicine CurrentSince Nov 1, 2015 Accepting new patients
Cogent Healthcare of Georgia PC Family Medicine CurrentSince Jan 1, 2021 Accepting new patients
South Sound Inpatient Physicians PLLC CurrentSince Nov 1, 2015 Accepting new patients
Kaiser Foundation Health Plan of the Northwest CurrentSince Nov 14, 2022 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Family Medicine CurrentSince Nov 14, 2022 Accepting new patients

Locations

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

400 Charter Blvd
Macon, GA 31210
Phone (478) 757-6000

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

890 Oak St SE
Salem, OR 97301
Phone (503) 585-0830

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021

400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Interoperability endpoints

  • Direct secure messaging: kkhan143@yourcarecommunity.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1215993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1194989723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 SW 162ND AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "97006",
            "telephone_number": "651-815-1038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NE MOTHER JOSEPH PLACE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643200",
            "telephone_number": "360-514-3727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "KASHIFF",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-14",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60222427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.