Individual provider Active NPI

Khalil I. Soboh, M.D

  • Internal Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1245544998
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
45940 Issued in KY
Practice address
2001 W 86TH St
Indianapolis, IN 46260-1902
Phone
(317) 338-2345
Fax
(317) 583-3099
NPI assigned
Aug 4, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01081174A IN
Internal Medicine Physician 207R00000X 45940 KY Primary
Internal Medicine Physician 207R00000X 242879 MA

Addresses

Primary practice location

2001 W 86TH St
Indianapolis, IN 46260-1902

Mailing address

PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 691-8070

Other practice location 1

1201 Pleasant Valley Rd
Owensboro, KY 42303
Phone (270) 417-4700

Other practice location 2

2100 Dorchester Ave
Carney Hospital
Dorchester Center, MA 02124-5615
Phone (617) 296-4000

Other identifiers 2

IdentifierTypeStateIssuer
201182970MedicaidIN
7100242400MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20130711000491 KY Practitioner - HospitalistPractitioner - Internal Medicine 5092955278 Reassigns benefits to 1 organization
I20250729002567 IN Practitioner - Internal Medicine 5092955278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2001 W 86TH St
Indianapolis, IN 46260-1902
Phone (317) 338-2345

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01081174AINMDInternal Medicine Physician
242879MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group, Inc Internal Medicine CurrentSince Jun 3, 2013 Accepting new patients
St Vincent Physician Services Hospital and Health Care Center Internal Medicine CurrentSince Sep 14, 2025 Accepting new patients
Owensboro Health Medical Group Inc Internal Medicine CurrentSince Jun 3, 2013 Accepting new patients
Owensboro Health Medical Group Inc Current Accepting new patients
St Vincent Physician Services Hospital and Health Care Center CurrentSince Sep 14, 2025 Accepting new patients
Owensboro Health Inc Past Accepting new patients

Locations

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331

8050 Township Line Rd
Indianapolis, IN 46260
Phone (317) 338-2442

8240 Naab Rd
Ste 155
Indianapolis, IN 46260
Phone (317) 338-7760

2211 Mayfair Dr
Ste 101
Owensboro, KY 42301
Phone (270) 688-1352

1201 Pleasant Valley Rd
Owensboro, KY 42303
Phone (270) 417-2000

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

Interoperability endpoints

  • Direct secure messaging: ksoboh1433524@direct.bsmhealth.org

Organizations & group practices 6

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 6

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": "1280880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1245544998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23229",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423043229",
            "telephone_number": "270-691-8070",
            "fax_number": "270-691-8026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601902",
            "telephone_number": "317-338-2345",
            "fax_number": "317-583-3099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 Pleasant Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Owensboro",
            "state": "KY",
            "postal_code": "42303",
            "country_code": "US",
            "telephone_number": "270-417-4700",
            "fax_number": "270-417-4709",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 Dorchester Ave",
            "address_2": "Carney Hospital",
            "address_purpose": "LOCATION",
            "city": "Dorchester Center",
            "state": "MA",
            "postal_code": "021245615",
            "country_code": "US",
            "telephone_number": "617-296-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOBOH",
        "first_name": "KHALIL",
        "middle_name": "I.",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-04",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01081174A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "45940",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "242879",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201182970",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100242400",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.