Individual provider Active NPI

Afshin A Khaiser, M.D.

  • Gastroenterology Physician
  • Galesburg, IL
National Provider Identifier
1255630646
Registry record updated Jul 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036136010 Issued in IL
Practice address
3315 N Seminary St
Galesburg, IL 61401-1251
Phone
(309) 344-1000
Fax
(309) 344-2405
NPI assigned
Mar 24, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036136010 IL Primary

Addresses

Primary practice location

3315 N Seminary St
Galesburg, IL 61401-1251

Mailing address

3315 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 344-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, FL2 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
I20140908002441 IL Practitioner - GastroenterologyPractitioner - Internal MedicinePractitioner - Hospitalist 8325267255 Reassigns benefits to 2 organizations
I20230803002015 FL Practitioner - Gastroenterology 8325267255 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Medical College of Wisconsin, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Collier Hma Physician Management LLCGroup PAC ID 2769495167, 99 clinicians

Practice addresses (Care Compare)

2500 Harbor Blvd
Port Charlotte, FL 33952-5000
Phone (239) 348-4236

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.8 of 100Reported as apm
Quality
77.6
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy118
Upper gastrointestinal (GI) endoscopy for acid reflux202

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036136010ILMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Key West Hma Physician Management LLC CurrentSince Apr 9, 2024 Accepting new patients
Key West Hma Physician Management, LLC Internal Medicine CurrentSince Apr 9, 2024 Accepting new patients
Collier Hma Physician Management LLC CurrentSince Aug 7, 2023 Accepting new patients
Methodist Medical Center of Illinois CurrentSince May 24, 2023 Accepting new patients
Advanced Telemedicine Associates LLC Internal Medicine CurrentSince Jan 1, 2023 Accepting new patients
Collier Hma Physician Management LLC Internal Medicine CurrentSince Aug 7, 2023 Accepting new patients
Proctor Health Systems Internal Medicine Past Accepting new patients

Locations

1111 12th St
Ste 104
Key West, FL 33040
Phone (305) 293-1830

8831 Founders Square Dr
Naples, FL 34120
Phone (239) 920-4503

8340 Collier Blvd
Ste 405
Naples, FL 34114
Phone (239) 348-4579

8300 Collier Blvd
Naples, FL 34114
Phone (239) 354-6000

6101 Pine Ridge Rd
Naples, FL 34119
Phone (239) 348-4000

6376 Pine Ridge Rd
Unit 300
Naples, FL 34119
Phone (239) 348-4128

2500 Harbor Blvd
Pt Charlotte, FL 33952
Phone (941) 766-4122

809 E Marion Ave
Punta Gorda, FL 33950
Phone (941) 625-1951

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

600 S 13th St
#D
Pekin, IL 61554
Phone (309) 353-7500

900 Main St
Ste 530
Peoria, IL 61602
Phone (309) 642-6705

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: afshin.khaiser.1@4692.direct.athenahealth.com

Organizations & group practices 8

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": "1300924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1255630646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3315 N SEMINARY ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011251",
            "telephone_number": "309-344-1000",
            "fax_number": "309-344-2405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 N SEMINARY ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011251",
            "telephone_number": "309-344-1000",
            "fax_number": "309-344-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAISER",
        "first_name": "AFSHIN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-24",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036136010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galesburg, IL

Sources for this page

Verify at the official NPI Registry.