Individual provider Active NPI

Usaamah Mahmood Khan, MD

  • Student in an Organized Health Care Education/Training Program
  • Boston, MA
National Provider Identifier
1215416078
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
0116031936 Issued in VA
Practice address
55 Fruit St. Department of Neurology, Mass Gen Brigham,
Wang 721-J
Boston, MA 02114
Phone
(860) 942-1670
Fax
(617) 724-6400
NPI assigned
Aug 12, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 0116031936 VA Primary

Addresses

Primary practice location

55 Fruit St. Department of Neurology, Mass Gen Brigham,
Wang 721-J
Boston, MA 02114

Mailing address

55 Fruit St. Department of Neurology, Mass Gen Brigham,
Wang 721-J
Boston, MA 02114
Phone (860) 942-1670

Other practice location 1

1250 E Marshall St # 980509
Richmond, VA 23298-5051
Phone (804) 489-7838

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20250819004301 VA Practitioner - Neurology 2163773821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

1250 E Marshall St
Richmond, VA 23219-5051
Phone (804) 828-9000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0116031936VAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
MCV Associated Physicians CurrentSince Jul 3, 2025 Accepting new patients

Locations

1250 E Marshall St
Richmond, VA 23298
Phone (804) 628-6990

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

1200 E Marshall St
Richmond, VA 23298
Phone (804) 827-0561

1250 E Marshall St
#980509
Richmond, VA 23298
Phone (804) 489-7838

Organizations & group practices 1

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": "1534032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1215416078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST. DEPARTMENT OF NEUROLOGY, MASS GEN BRIGHAM,",
            "address_2": "WANG 721-J",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "860-942-1670",
            "fax_number": "617-724-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST. DEPARTMENT OF NEUROLOGY, MASS GEN BRIGHAM,",
            "address_2": "WANG 721-J",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "860-942-1670",
            "fax_number": "617-724-6400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 E Marshall St # 980509",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985051",
            "country_code": "US",
            "telephone_number": "804-489-7838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "USAAMAH",
        "middle_name": "MAHMOOD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-12",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116031936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.