Hafiz Khattak, M.D.

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

2000161127 Issued in MO

Practice address

7491 Big Bend Blvd
Webster Groves, MO 63119-2101

Phone

(314) 961-3038

Fax

(618) 398-6266

NPI assigned

Dec 28, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO, IL2 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

Specialty

Physical Medicine and RehabilitationAlso: Interventional Pain Management

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

25.83 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

86.1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• American Pain Management and Rehab LLC

  • Interventional Pain Medicine Physician
  • Webster Groves, MO
  • NPI 1285960963

  IL

  Medicare reassignment NPD Authorized official
• Interventional Center for Pain

  • Specialist
  • Saint Louis, MO
  • NPI 1508067208
  NPD (past)
• Medical Care LLC

  • Health Service Clinic/Center
  • Florissant, MO
  • NPI 1609481696
  NPD (past)

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1265419683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2153 DEPT 30703",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352879256",
            "telephone_number": "314-961-3038",
            "fax_number": "314-961-6731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7491 BIG BEND BLVD",
            "city": "WEBSTER GROVES",
            "state": "MO",
            "postal_code": "631192101",
            "telephone_number": "314-961-3038",
            "fax_number": "618-398-6266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Park Pl Ste A",
            "address_purpose": "LOCATION",
            "city": "Swansea",
            "state": "IL",
            "postal_code": "622262929",
            "country_code": "US",
            "telephone_number": "618-398-6266",
            "fax_number": "618-398-6293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHATTAK",
        "first_name": "HAFIZ",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MO",
            "license": "2000161127",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036101887",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "MO",
            "license": "2000161127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205739006",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly D Jones, PLPC
• Susan Jones, MA-CCC-SP
• Lauren Ann Kavanaugh, DENTAL HYGIENE ASSIS
• Marjorie Kelly, R.D., L.D.
• Yostena Khalil
• Donald K King, M.D.
• Alice K Kinsella, LPC
• Christina Klasing, RN
• Melanie J Kramer, NP-C
• Kristan Wilson LLC

• Pain Medicine Physician in Webster Groves, MO
• Providers in Webster Groves, MO by specialty
• Pain Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; 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.