Individual provider Active NPI

Abdul Moiz Khan, MD

  • Medical Oncology Physician
  • Rockford, IL
National Provider Identifier
1295211373
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
036167261 Issued in IL
Practice address
3535 N Bell School Rd
Rockford, IL 61114-6624
Phone
(779) 696-9400
Fax
(779) 696-9365
NPI assigned
Jul 12, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 64034
Medical Oncology Physician 207RX0202X 036167261 IL Primary

Addresses

Primary practice location

3535 N Bell School Rd
Rockford, IL 61114-6624

Mailing address

47 New Scotland Ave Dept of Internal Medicine
Albany, NY 12208-3412
Phone (518) 262-3095

Other practice location 1

47 New Scotland Ave Dept Of Internal Medicine
Albany, NY 12208-3412
Phone (518) 262-3095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20240802000480 IL Practitioner - Internal MedicinePractitioner - Medical Oncology 6002151925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Medical Oncology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedishamerican HospitalGroup PAC ID 5799698346, 386 clinicians

Practice addresses (Care Compare)

3535 N Bell School Rd
Regional Cancer Center
Rockford, IL 61114-6624
Phone (779) 696-9400

Hospital & facility affiliations

  • Uw Health Hospital, Rockford, IL, CCN 140228

Merit-based Incentive Payment System (MIPS)

Final score
81.51 of 100Reported as group
Quality
83.2
Promoting interoperability
77
Improvement activities
40
Cost
71.7

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036167261ILMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedishamerican Hospital CurrentSince Jul 8, 2024 Accepting new patients
Swedishamerican Hospital CurrentSince Jul 8, 2024 Accepting new patients
Swedishamerican Hospital Current Accepting new patients

Locations

6824 Newburg Rd
Rockford, IL 61108
Phone (779) 696-7610

2550 Charles St
Rockford, IL 61108
Phone (779) 696-7285

3535 N Bell School Rd
Rockford, IL 61114
Phone (779) 696-9400

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 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": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1295211373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 NEW SCOTLAND AVE DEPT OF INTERNAL MEDICINE",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083412",
            "telephone_number": "518-262-3095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 N BELL SCHOOL RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611146624",
            "telephone_number": "779-696-9400",
            "fax_number": "779-696-9365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47 New Scotland Ave Dept Of Internal Medicine",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "NY",
            "postal_code": "122083412",
            "country_code": "US",
            "telephone_number": "518-262-3095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "ABDUL MOIZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-12",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": "64034",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "IL",
            "license": "036167261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.