Individual provider Active NPI

Amirah Nabiyah Khan, M.D.

  • Gastroenterology Physician
  • Brockton, MA
National Provider Identifier
1265775225
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
266511 Issued in MA
Practice address
189 Quincy St
Brockton, MA 02302-2967
Phone
(508) 588-6700
Fax
(508) 584-3010
NPI assigned
Mar 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2021

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 266511 MA Primary

Addresses

Primary practice location

189 Quincy St
Brockton, MA 02302-2967

Mailing address

189 Quincy St
Brockton, MA 02302-2967
Phone (508) 588-6700

Other practice location 1

35 Summer St
Taunton, MA 02780-3469
Phone (508) 821-4100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20180928000071 MA Practitioner - GastroenterologyPractitioner - Internal Medicine 7315233269 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
University of Florida College of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gis Services 2 LLCGroup PAC ID 1355674755, 10 clinicians
Gastrointestinal Specialists, LLCGroup PAC ID 9638107451, 10 clinicians

Practice addresses (Care Compare)

189 Quincy St
Brockton, MA 02302-2967
Phone (508) 588-6700

Hospital & facility affiliations

  • Signature Healthcare Brockton Hospital Hospital, Brockton, MA, CCN 220052
  • Brown University Health Morton Hospital Hospital, Taunton, MA, CCN 220073

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy98
Upper gastrointestinal (GI) endoscopy for acid reflux97

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians of Massachusetts II PC CurrentSince Oct 1, 2018 Accepting new patients
Gastrointestinal Specialists, LLC Gastroenterology CurrentSince Aug 5, 2019 Accepting new patients

Locations

189 Quincy St
Brockton, MA 02302
Phone (508) 588-6700

1 Donalds Way
Ste 203
East Bridgewater, MA 02333
Phone (508) 350-2940

575 Beech St
Holyoke, MA 01040
Phone (413) 534-2570

35 Summer St
Taunton, MA 02780
Phone (508) 822-4100

35 Summer St
Ste 201
Taunton, MA 02780
Phone (508) 821-4100

Interoperability endpoints

  • Direct secure messaging: akhan448822@direct.bilh.masshiway.net

Organizations & group practices 3

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 2

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": "1364428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1265775225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 QUINCY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022967",
            "telephone_number": "508-588-6700",
            "fax_number": "508-584-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 QUINCY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022967",
            "telephone_number": "508-588-6700",
            "fax_number": "508-584-3010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Summer St",
            "address_purpose": "LOCATION",
            "city": "Taunton",
            "state": "MA",
            "postal_code": "027803469",
            "country_code": "US",
            "telephone_number": "508-821-4100",
            "fax_number": "508-822-2367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "AMIRAH",
        "middle_name": "NABIYAH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-28",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MA",
            "license": "266511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.