Prashant Khetpal, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

129407 Issued in WA

Practice address

6644 E Baywood Ave
Mesa, AZ 85206-1747

Phone

(602) 778-3600

NPI assigned

Jul 11, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA, AR, DC3 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

Specialty

Internal Medicine

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holy Cross Germantown Hospital Hospital, Germantown, MD, CCN 210065
• Holy Cross Hospital Hospital, Silver Spring, MD, CCN 210004

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16686/brand/1/csg/1/fhir/r4

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.

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Annapolis, MD
  • NPI 1952461816

  DC, Internal Medicine

  Medicare reassignment Care Compare group NPD
• Apogee Medical Group Virginia, PC

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1861660540

  VA

  Medicare reassignment NPD
• Inova Health Care Services

  • Internal Medicine Physician
  • Falls Church, VA
  • NPI 1952320061

  DC

  Medicare reassignment NPD
• Saline Clinics LLC

  • Gastroenterology Physician
  • Benton, AR
  • NPI 1447609367

  Internal Medicine

  Medicare reassignment NPD
• Southeast Arkansas Hospitalists, LLP

  • Hospitalist Physician
  • Pine Bluff, AR
  • NPI 1912374018
  Medicare reassignment NPD
• Inova Health Care Services

  • Substance Abuse Rehabilitation Facility
  • Falls Church, VA
  • NPI 1588717755
  NPD
• Inova Health Care Services

  • Multi-Specialty Clinic/Center
  • Fairfax, VA
  • NPI 1669511051
  NPD
• Inova Health Care Services

  • Medical Technologist
  • Sterling, VA
  • NPI 1699655589
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • MC Lean, VA
  • NPI 1376815472
  NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD
• Apogee Medical Group, Louisiana, Inc.

  • Specialist
  • Scottsdale, AZ
  • NPI 1932347903
  NPD (past)
• Ipn of Arizona, PLC

  • Internal Medicine Physician
  • Glendale, AZ
  • NPI 1538119284
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Holy Cross Health, Inc

  • General Acute Care Hospital
  • Silver Spring, MD
  • NPI 1669417838
  Care Compare affiliation
• Holy Cross Health, Inc.

  • General Acute Care Hospital
  • Germantown, MD
  • NPI 1245655638
  Care Compare affiliation
• Holy Cross Health, Inc.

  • Clinical Medical Laboratory
  • Silver Spring, MD
  • NPI 1831574284

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1215136148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 708850",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840708850",
            "telephone_number": "866-869-2395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6644 E BAYWOOD AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061747",
            "telephone_number": "602-778-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHETPAL",
        "first_name": "PRASHANT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-11",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "129407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000544849",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "c-cda",
            "address_1": "1500 Forest Glen Rd",
            "city": "Silver Spring",
            "state": "MD",
            "country_code": "US",
            "postal_code": "209101460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joseph Khatchadourian, M.D.
• Marie V Khatinha, FNP- BC
• Muhammad Musa Khattak, DO
• Jackton Simiyu Khausi, OTRL
• Rana Khaznadar, M.D.
• Jennifer Thuy Tien Khong
• Brittany Khoury, PMHNP
• Fadi Munir Khoury, M.D.
• Sandra Olivia Khumalo
• Thao Khuong

• Internal Medicine Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.