Individual provider Active NPI

Shams Khan, MD

  • Internal Medicine Physician
  • Wyoming, MN
National Provider Identifier
1306889225
Registry record updated Mar 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
39493 Issued in MN
Practice address
5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone
(651) 982-7430
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 39493 MN Primary

Addresses

Primary practice location

5200 Fairview Blvd
Wyoming, MN 55092-8013

Mailing address

2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone (612) 672-2575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20041028000221 MN Practitioner - Internal Medicine 7113989682 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Health ServicesGroup PAC ID 1951213057, 677 clinicians

Practice addresses (Care Compare)

14101 Fairview Dr
Burnsville, MN 55337-2537

1700 University Ave W
Saint Paul, MN 55104-3727

5200 Fairview Blvd
Wyoming, MN 55092-8013
Phone (651) 982-7000

911 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-1313

919 Northland Dr
Princeton, MN 55371-2172
Phone (763) 389-3344

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39493MNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Region Healthcare Corporation CurrentSince Nov 1, 2013 Accepting new patients
Healtheast Medical Research Institute Internal Medicine CurrentSince Feb 17, 2019 Accepting new patients
Fairview Clinics CurrentSince Mar 1, 2020 Accepting new patients
Healtheast Woodwinds Hospital CurrentSince Mar 1, 2020 Accepting new patients
Healtheast St. John's Hospital CurrentSince Mar 1, 2020 Accepting new patients
Fairview Health Services Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Feb 17, 2019 Accepting new patients
Fairview Clinics CurrentSince Oct 25, 2010 Accepting new patients
Fairview Clinics CurrentSince Mar 1, 2020 Accepting new patients
Healtheast Care System CurrentSince Mar 1, 2020 Accepting new patients
Fairview Bethesda Hospital CurrentSince Mar 1, 2020 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Nov 1, 2013 Accepting new patients
Fairview Health Services CurrentSince Oct 25, 2010 Accepting new patients
Fairview Clinics Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Columbia Park Medical Group, PA Internal Medicine Past Accepting new patients
Fairview Health Services Past Accepting new patients

Locations

13819 Hanson Blvd NW
Andover, MN 55304
Phone (763) 572-5700

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

201 E Nicollet Blvd
Burnsville, MN 55337
Phone (952) 892-2000

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

712 S Cascade St
Fergus Falls, MN 56537

6341 University Ave NE
Minneapolis, MN 55432
Phone (763) 427-9980

6401 France Ave S
Minneapolis, MN 55435
Phone (952) 920-8477

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

400 Stinson Blvd
#2
Minneapolis, MN 55413
Phone (612) 672-2294

550 Osborne Rd NE
Minneapolis, MN 55432
Phone (763) 236-3800

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

4050 Coon Rapids Blvd NW
Minneapolis, MN 55433
Phone (763) 236-6786

10000 Zane Ave N
Minneapolis, MN 55443
Phone (763) 528-6999

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

919 Northland Dr
Princeton, MN 55371
Phone (763) 389-3344

3300 Oakdale Ave N
Robbinsdale, MN 55422
Phone (763) 520-5048

69 Exchange St W
Saint Paul, MN 55102
Phone (651) 232-1100

559 Capitol Blvd
Saint Paul, MN 55103
Phone (651) 232-2000

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

1925 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-0100

5200 Fairview Blvd
Wyoming, MN 55092
Phone (651) 464-4611

Interoperability endpoints

  • Direct secure messaging: skhan121836@fairview.direct-ci.com
  • FHIR API: https://fhir-myrecord.cerner.com/r4/e35355ac-dfca-48b9-9dd9-0b7c408c2a66/

Organizations & group practices 18

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.

View all 18

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1306889225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 RIVERSIDE AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541450",
            "telephone_number": "612-672-2575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 FAIRVIEW BLVD",
            "city": "WYOMING",
            "state": "MN",
            "postal_code": "550928013",
            "telephone_number": "651-982-7430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SHAMS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "39493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MN

Sources for this page

Verify at the official NPI Registry.