Active NPI
Hadi Mohammad Khan, M.D.
- Surgery Physician
- Green Bay, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 64318-20
- Practice address
- 720 S Vanburen St
Suite 201
Green Bay, WI 54301-3534 - Phone
- (920) 433-7488
- Fax
- (920) 433-7439
- NPI assigned
- Apr 7, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 13520 | SD | |
| Surgery Physician | 208600000X | 64318-20 | WI | Primary |
Addresses
Primary practice location
720 S Vanburen St
Suite 201
Green Bay, WI 54301-3534
Mailing address
PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7222
Other practice location 1
3015 3rd Ave SE
Aberdeen, SD 57401-5418
Phone (605) 226-5500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64318-20 | Other | WI | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, NM, SD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2905 3Rd Ave SE
Aberdeen, SD 57401-5420
Phone (605) 626-4200
701 3Rd Ave S
Clear Lake, SD 57226-2016
Phone (605) 874-2141
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sanford Health Network | Current | Accepting new patients | |
| Agnesian Healthcare Inc | Surgery | Current | Accepting new patients |
| Sanford Health Network | Current | Accepting new patients | |
| Divine Savior Healthcare, Inc. | Current | Accepting new patients | |
| Dean Health Systems, Inc | Current | Accepting new patients | |
| Sanford Health Network | Current | Accepting new patients | |
| Agnesian Healthcare, Inc | Current | Accepting new patients | |
| Dean Health Systems, Inc. | Current | Accepting new patients | |
| Agnesian Healthcare Inc | Current | Accepting new patients | |
| Divine Savior Healthcare, Inc. | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Surgery | Past | Accepting new patients |
Locations
29980 Network Pl
Chicago, IL 60673
701 3rd Ave S
Clear Lake, SD 57226
Phone (605) 874-2141
4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000
20 S Plum St
Vermillion, SD 57069
Phone (605) 624-2611
901 4th St NW
Watertown, SD 57201
Phone (605) 882-8780
430 E Division St
Fond du Lac, WI 54935
Phone (920) 926-4200
420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400
3400 E Racine St
Janesville, WI 53546
Phone (608) 373-8000
1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497
360 S Mountin Dr
Mayville, WI 53050
Phone (920) 387-2111
515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000
2817 New Pinery Rd
Portage, WI 53901
Phone (608) 745-4598
620 W Brown St
Waupun, WI 53963
Phone (920) 324-5581
Interoperability endpoints
- hkhan@yourcarecommunity.org
- hkhan509862@direct-ehr-ssmhc.com
Organizations & group practices 13
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.
-
dba Sanford Care Center Vermillion
- Critical Access Hospital
- Vermillion, SD
- NPI 1790721280
-
dba SSM Health St Agnes Hospital Fond Du Lac
- General Acute Care Hospital
- Fond Du Lac, WI
- NPI 1346228541
-
dba SSM Health Dean Medical Group
- Allergy & Immunology Physician
- Madison, WI
- NPI 1053358846
-
dba Aspirus Divine Savior Hospital
- General Acute Care Hospital
- Portage, WI
- NPI 1124083894
-
dba CHRISTUS St. Vincent Pediatrics
- Pediatrics Physician
- Santa Fe, NM
- NPI 1063367803
-
dba SSM Health Fond Du Lac Regional Clinic
- Family Medicine Physician
- Fond Du Lac, WI
- NPI 1730162991
Surgery
-
dba SSM Health Davis Duehr Dean Eye Care - Portage
- Durable Medical Equipment & Medical Supplies
- Portage, WI
- NPI 1427085679
-
dba Aspirus Portage Clinic
- Rural Health Clinic/Center
- Portage, WI
- NPI 1386154417
-
dba Sanford Clinic Vermillion
- Family Medicine Physician
- Vermillion, SD
- NPI 1013921733
-
dba Sanford Clinic Mountain Lake
- Rural Health Clinic/Center
- Mountain Lake, MN
- NPI 1568469039
-
dba Sanford Ipswich Clinic
- Rural Health Clinic/Center
- Ipswich, SD
- NPI 1962459842
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Sanford Aberdeen Medical Center
- General Acute Care Hospital
- Aberdeen, SD
- NPI 1235406455
-
dba Sanford Aberdeen Cardiology
- General Acute Care Hospital
- Aberdeen, SD
- NPI 1639423957
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207526400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750032000000",
"number": "1265605679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 22487",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543052487",
"telephone_number": "920-445-7222",
"fax_number": "920-445-7289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "720 S VANBUREN ST",
"address_2": "SUITE 201",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543013534",
"telephone_number": "920-433-7488",
"fax_number": "920-433-7439"
}
],
"practiceLocations": [
{
"address_1": "3015 3rd Ave SE",
"address_purpose": "LOCATION",
"city": "Aberdeen",
"state": "SD",
"postal_code": "574015418",
"country_code": "US",
"telephone_number": "605-226-5500",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KHAN",
"first_name": "HADI",
"middle_name": "MOHAMMAD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-07",
"last_updated": "2025-06-16",
"certification_date": "2025-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "SD",
"license": "13520",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WI",
"license": "64318-20",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "64318-20",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; 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.