Khalid Fathi Abd-Al Rauoof Afaneh, M,B.B,S

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

0440684 Issued in KS

Practice address

9300 E 29TH St N Ste 208
Wichita, KS 67226-2183

Phone

(800) 373-4222

Fax

(316) 652-0340

NPI assigned

Jul 10, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557878400000",
    "number": "1316202096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3462",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672013462",
            "telephone_number": "800-373-4222",
            "fax_number": "316-652-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 E 29TH ST N STE 208",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672262183",
            "telephone_number": "800-373-4222",
            "fax_number": "316-652-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AFANEH",
        "first_name": "KHALID",
        "middle_name": "FATHI ABD-AL RAUOOF",
        "name_prefix": "Dr.",
        "credential": "M,B.B,S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-10",
        "last_updated": "2019-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZH0000X",
            "taxonomy_group": "",
            "desc": "Pathology, Hematology",
            "state": "KS",
            "license": "0440684",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "63165",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KS",
            "license": "0440684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anatomic Pathology & Clinical Pathology Physician in Wichita, KS
• Providers in Wichita, KS by specialty
• Anatomic Pathology & Clinical Pathology Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.