Jakaulla Khan, MD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

37755 Issued in AZ

Practice address

1003 Main Ave
Clifton, NJ 07011-2333

Phone

(973) 777-9595

NPI assigned

Oct 13, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Infectious Disease

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kingman Regional Medical Center Hospital, Kingman, AZ, CCN 030055

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: khan.jakulla@st.direct.azkrmc.md
• Direct secure messaging: khan.jakulla@direct.azkrmc.md

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.

• J. Khan, LLC

  • Infectious Disease Physician
  • Kingman, AZ
  • NPI 1003076712
  Medicare reassignment NPD
• Kingman Healthcare, Inc

  • General Acute Care Hospital
  • Kingman, AZ
  • NPI 1265423917
  NPD
• Kingman Healthcare, Inc

  • Specialist
  • Kingman, AZ
  • NPI 1689897787

  Internal Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kingman Healthcare, Inc

  • General Acute Care Hospital
  • Kingman, AZ
  • NPI 1265423917
  Care Compare affiliation

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1306936349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1739 E BEVERLY AVE",
            "address_2": "STE 208",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093593",
            "telephone_number": "201-512-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 MAIN AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070112333",
            "telephone_number": "973-777-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "JAKAULLA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "AZ",
            "license": "37755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6707301",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aisha Khalid, PHARMD, RPH
• Ava Khalil, LSW
• Samir Walid Khalil, MD
• Serag Ibrahim Khamis, DMD
• Farhana H Khan, MD
• Roohi Khanna, D.O
• Linda A Khatib, PSY.D.
• Omar Nassim Khatib, M.D.
• Merna Marlin Refat Khilla, OD
• Kathleen D Kho

• Infectious Disease Physician in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Infectious Disease Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; 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.

Verify at the official NPI Registry.