NPIMap

Individual provider Active NPI

Khaled Chan, MD

  • Internal Medicine Physician
  • Westminster, CA
National Provider Identifier
1255376414
Registry record updated Dec 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A56081 Issued in CA
Practice address
7955 Westminster Blvd
Westminster, CA 92683-4001
Phone
(714) 379-3221
Fax
(714) 379-3211
NPI assigned
Jun 19, 2006
Last updated
Dec 2, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2011

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A56081 CA Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X A56081 CA
Pulmonary Disease Physician 207RP1001X A56081 CA
Hospitalist Physician 208M00000X A56081 CA

Addresses

Primary practice location

7955 Westminster Blvd
Westminster, CA 92683-4001

Mailing address

PO Box 2989
Seal Beach, CA 90740-1989
Phone (714) 379-3221

Other identifiers 1

IdentifierTypeStateIssuer
00A560810MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040126000900 CA Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Sleep MedicinePractitioner - Critical Care (Intensivists) 9335041615 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine, Sleep Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pathway Medical Group IncGroup PAC ID 5092776690, 17 clinicians

Practice addresses (Care Compare)

12462 Brookhurst St
Suite Aandb
Garden Grove, CA 92840-4759
Phone (714) 636-9852

12665 Garden Grove Blvd
Suite 502Aandb
Garden Grove, CA 92843-1901
Phone (714) 537-7800

7955 Westminster Blvd
Westminster, CA 92683-4001
Phone (714) 379-3221

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.74 of 100Reported as individual
Quality
60.23
Promoting interoperability
80
Improvement activities
40
Cost
62.25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A56081CAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathway Medical Group, Inc Internal Medicine CurrentSince Nov 1, 2004 Accepting new patients
Pathway Medical Group, Inc. Internal Medicine CurrentSince May 12, 2004 Accepting new patients
Pathway Medical Group, Inc Current Accepting new patients
Pathway Medical Group, Inc Internal Medicine Past Accepting new patients
Memorial Medical Group Inc Past Accepting new patients
Orange Coast Memorial Medical Center Past Accepting new patients
South Coast Global Medical Center, Inc Past Accepting new patients

Locations

12665 Garden Grove Blvd
Ste 502AB
Garden Grove, CA 92843
Phone (714) 537-7800

7955 Westminster Blvd
Westminster, CA 92683
Phone (714) 379-2411

7955 Westminster Blvd
Ste 403
Westminster, CA 92683

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Healthcare Center of Orange CountyBuena Park, CA, CCN 055674 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 27, 2020
Jan 27, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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 5

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": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322784000000",
    "number": "1255376414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2989",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907401989",
            "telephone_number": "714-379-3221",
            "fax_number": "714-379-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7955 WESTMINSTER BLVD",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926834001",
            "telephone_number": "714-379-3221",
            "fax_number": "714-379-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAN",
        "first_name": "KHALED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2011-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A56081",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "CA",
            "license": "A56081",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A56081",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A56081",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A560810",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CA

Sources for this page

Verify at the official NPI Registry.