Organization Active NPI

Mija Khan MD PLLC

  • Plastic Surgery Physician
  • Scottsdale, AZ
National Provider Identifier
1326705997
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
MIJA KHAN MD PLLC
Practice address
8994 E Desert Cove Ave
Scottsdale, AZ 85260-7901
Phone
(480) 551-2040
NPI assigned
Nov 18, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Authorized official

Name
Brittany Boyer
Title
Authorized
Phone
(209) 956-7732

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

8994 E Desert Cove Ave
Scottsdale, AZ 85260-7901

Mailing address

PO Box 7096
Stockton, CA 95267-0096
Phone (209) 956-7725

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220222001033 AZ Part B Supplier - Clinic/Group Practice 8426442286 Receives reassigned benefits from 1 practitioner
Practice locations: Scottsdale, AZ

National Provider Directory

National Provider Directory

Locations

3301 N Miller Rd
Ste 175
Scottsdale, AZ 85251
Phone (480) 551-2040

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1637193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712016000000",
    "number": "1326705997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7096",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952670096",
            "telephone_number": "209-956-7725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8994 E DESERT COVE AVE",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852607901",
            "telephone_number": "480-551-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIJA KHAN MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-18",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A",
        "authorized_official_last_name": "BOYER",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "AUTHORIZED",
        "authorized_official_telephone_number": "209-956-7732"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.