Khaled A. Sultani

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

122509 Issued in MA

Practice address

27 Mechanic St
Worcester, MA 01608

Phone

(508) 841-3764

NPI assigned

Dec 10, 2020

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

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

University of Connecticut School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Behavioral Nutrition IncGroup PAC ID 6507297215, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Behavioral Nutrition Inc

  • Mental Health Counselor
  • Quincy, MA
  • NPI 1851686455
  Medicare reassignment Care Compare group NPD
• Global Community Comprehensive Psychiatric Care

  • Psychiatric/Mental Health Nurse Practitioner
  • Worcester, MA
  • NPI 1427719210
  Medicare reassignment NPD
• Vitaliy Medical Aesthetics

  • Family Medicine Physician
  • Worcester, MA
  • NPI 1790404713
  NPD (past)

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1235735663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 MECHANIC ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01608",
            "telephone_number": "508-841-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 MECHANIC ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01608",
            "telephone_number": "508-841-3764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULTANI",
        "first_name": "KHALED",
        "middle_name": "A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-10",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "122509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel R Sullivan
• Ryan Delano Sullivan, MD
• Shawna Sullivan, OTR/L
• Ivelisse Sully
• Danielle Aysha Sultan, DO
• Stephen Mark Summers, M.D.
• Summit Academy, Inc.
• Summit Psychiatry
• Concetta Marie Sumner
• Sun Dental Center

• Clinical Social Worker in Worcester, MA
• Providers in Worcester, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.