Individual provider Active NPI

Sophia Janjua Khan, M.D.

  • Gastroenterology Physician
  • Oklahoma City, OK
National Provider Identifier
1285606491
Registry record updated Jul 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
28637 Issued in OK
Practice address
4205 McAuley Blvd Ste 375
Oklahoma City, OK 73120
Phone
(405) 749-4247
Fax
(405) 749-4249
NPI assigned
Feb 2, 2006
Last updated
Jul 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 01051448 IN
Gastroenterology Physician 207RG0100X 28637 OK Primary

Addresses

Primary practice location

4205 McAuley Blvd Ste 375
Oklahoma City, OK 73120

Mailing address

4205 McAuley Blvd Ste 375
Oklahoma City, OK 73120-9309
Phone (405) 749-4247

Other identifiers 1

IdentifierTypeStateIssuer
200220940AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20120410000312 OK Practitioner - Gastroenterology 0244284396 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

4205 McAuley Blvd
Suite 375
Oklahoma City, OK 73120-9309
Phone (405) 751-4343

4300 McAuley Blvd
Oklahoma City, OK 73120-8302
Phone (405) 936-5455

4300 W Memorial Rd
Oklahoma City, OK 73120-8304
Phone (405) 755-1515

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy203
Upper gastrointestinal (GI) endoscopy for acid reflux198

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28637OKMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Healthcare Associates, P.C. Gastroenterology Current Accepting new patients
Mercy Clinic Oklahoma Communities CurrentSince Feb 2, 2012 Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients

Locations

2206 Roosevelt Rd
Ste A
Valparaiso, IN 46383
Phone (219) 464-2285

4205 McAuley Blvd
Ste 375
Oklahoma City, OK 73120
Phone (405) 749-4247

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

4300 W Memorial Rd
Oklahoma City, OK 73120
Phone (405) 752-3962

Interoperability endpoints

  • Direct secure messaging: skhan223719@directc.mercy.net

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531958400000",
    "number": "1285606491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 MCAULEY BLVD STE 375",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731209309",
            "telephone_number": "405-749-4247",
            "fax_number": "405-749-4249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 MCAULEY BLVD STE 375",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73120",
            "telephone_number": "405-749-4247",
            "fax_number": "405-749-4249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SOPHIA",
        "middle_name": "JANJUA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2018-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IN",
            "license": "01051448",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OK",
            "license": "28637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200220940A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.