Individual provider Active NPI

Muhammad Khurshid Khan, PA-C

  • Physician Assistant
  • Hayward, CA
National Provider Identifier
1215234737
Registry record updated Feb 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA21468 Issued in CA
Practice address
1090 La Playa Dr
Hayward, CA 94545-2142
Phone
(510) 785-5555
NPI assigned
Feb 18, 2011
Last updated
Feb 18, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA21468 CA Primary

Addresses

Primary practice location

1090 La Playa Dr
Hayward, CA 94545-2142

Mailing address

814 Hancock St Apt 702
Hayward, CA 94544-4981
Phone (510) 862-8336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110401000718 CA Practitioner - Physician Assistant 9436333259 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Gautam Pareek MD IncGroup PAC ID 4486026747, 4 clinicians

Practice addresses (Care Compare)

1090 La Playa Dr
Hayward, CA 94545-2142
Phone (510) 796-7796

15921 E 14TH St
San Leandro, CA 94578-3005
Phone (510) 796-7796

3755 Beacon Ave
Fremont, CA 94538-1411
Phone (510) 796-7796

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
48.93 of 100Reported as individual
Quality
35
Improvement activities
0
Cost
88.2

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21468CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Medical Group PC PastSince Jul 1, 2023 Accepting new patients
Nirmala Kannan M.D. a Professional Corporation Past Accepting new patients
Nirmala Kannan, M.D. Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

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 2

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": "1297987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297987200000",
    "number": "1215234737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 HANCOCK ST APT 702",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945444981",
            "telephone_number": "510-862-8336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 LA PLAYA DR",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945452142",
            "telephone_number": "510-785-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MUHAMMAD",
        "middle_name": "KHURSHID",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-18",
        "last_updated": "2011-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA21468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, CA

Sources for this page

Verify at the official NPI Registry.