Active NPI
Mohammad Azeem Khan, MD
- Family Medicine Physician
- Wichita Falls, TX
National Provider Identifier
1285920173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- BP10037618
- Practice address
- 1301 3Rd St
Wichita Falls, TX 76301-2245 - Phone
- (940) 767-5145
- NPI assigned
- Jun 20, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | BP10037618 | TX | Primary |
Addresses
Primary practice location
1301 3Rd St
Wichita Falls, TX 76301-2245
Mailing address
6016 Van Dorn Dr
Wichita Falls, TX 76310-2828
Phone (773) 716-4733
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140721001915 | PA | Practitioner - Family Practice | 0446476865 | Reassigns benefits to 1 organization |
| I20190529000876 | TX | Practitioner - Family Practice | 0446476865 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lawton Indian Hospital
Practice addresses (Care Compare)
1515 NE Lawrie Tatum Rd
Lawton, OK 73507-3002
Phone (580) 354-5000
Hospital & facility affiliations
- Complete Home Health of Tishomingo LLC
- Enhabit Home Health of Western Oklahoma
- Lawton Indian Hospital
- Memorial Health
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BP10037618 | TX | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spuc, LLC | Current | Accepting new patients | |
| Lawton Indian Hospital | Current | Accepting new patients | |
| Jackson County Memorial Hospital Authority | Past | Accepting new patients |
Locations
1515 NE Lawrie Tatum Rd
Lawton, OK 73507
Phone (580) 353-0350
1444 W Passyunk Ave
Philadelphia, PA 19145
Phone (215) 389-4444
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 and National Provider Directory roles.
-
- Ambulatory Surgical Clinic/Center
- Lawton, OK
- NPI 1407023187
-
- General Acute Care Hospital
- Altus, OK
- NPI 1093763781
Hospital & facility affiliations 11
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Federal Public Health Clinic/Center
- Anadarko, OK
- NPI 1881637403
Hospital
-
- Federal Public Health Clinic/Center
- Carnegie, OK
- NPI 1457459158
Hospital
-
- Federal Public Health Clinic/Center
- Clinton, OK
- NPI 1205923448
Hospital
-
- Home Health Agency
- Tishomingo, OK
- NPI 1891116232
-
- Home Health Agency
- Lawton, OK
- NPI 1558616342
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308528000000",
"number": "1285920173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6016 VAN DORN DR",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763102828",
"telephone_number": "773-716-4733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 3RD ST",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763012245",
"telephone_number": "940-767-5145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "MOHAMMAD",
"middle_name": "AZEEM",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-20",
"last_updated": "2011-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "BP10037618",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wichita Falls, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2011; 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.