Suresh K Khetan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D55403 Issued in MD

Practice address

7610 Carroll Ave
Suite 260
Takoma Park, MD 20912

Phone

(301) 891-9770

Fax

(301) 891-1620

NPI assigned

Jul 4, 2006

Sex

Male

Sole proprietor

Yes

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 DC

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Complete Family Care PC

  • Family Medicine Physician
  • Takoma Park, MD
  • NPI 1760560031
  Authorized official Same address or phone

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197936000000",
    "number": "1265462139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7398",
            "city": "LANGLEY PARK",
            "state": "MD",
            "postal_code": "207877398",
            "telephone_number": "301-963-3456",
            "fax_number": "301-963-0424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7610 CARROLL AVE",
            "address_2": "SUITE 260",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "20912",
            "telephone_number": "301-891-9770",
            "fax_number": "301-891-1620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHETAN",
        "first_name": "SURESH",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D55403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kes Healthcare Services, Inc
• Kes Healthcare Services, Inc
• Elsa Kevin, LCPC
• Catherine Keyaka
• Maham Khan, M.D.
• Joan Kidola
• Kidz & Family Dental Center LLC (Kidz & Family Dental Center)
• Maria Liza Flores Kilby, M.D.
• Cosmas K Kileo
• Louis Raymond Knight, LCSW-C

• Family Medicine Physician in Takoma Park, MD
• Providers in Takoma Park, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.