NPIMap

Individual provider Active NPI

Mariam Khan, MD

  • Rheumatology Physician
  • Harrisburg, PA
National Provider Identifier
1346411824
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
MD439594 Issued in PA
Practice address
810 Sir Thomas CT Ste 101
Harrisburg, PA 17109-4839
Phone
(717) 614-4420
Fax
(717) 614-4421
NPI assigned
Mar 12, 2008
Last updated
Dec 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 57.014380 OH
Rheumatology Physician 207RR0500X MD439594 PA Primary

Addresses

Primary practice location

810 Sir Thomas CT Ste 101
Harrisburg, PA 17109-4839

Mailing address

810 Sir Thomas CT Ste 101
Harrisburg, PA 17109-4839
Phone (717) 614-4420

Other identifiers 1

IdentifierTypeStateIssuer
102537799MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mkhan5859@phsdirect.pinnaclehealth.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101027001328 PA Practitioner - RheumatologyPractitioner - Internal Medicine 1355535964 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pinnacle Health Medical ServicesGroup PAC ID 7618960493, 1,025 clinicians

Practice addresses (Care Compare)

810 Sir Thomas CT
Suite 101
Harrisburg, PA 17109-4839
Phone (717) 614-4420

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.08 of 100Reported as group
Quality
76.48
Promoting interoperability
100
Improvement activities
40
Cost
77.12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57.014380OHMDRheumatology Physician
MD439594PAMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Health Medical Services CurrentSince Aug 9, 2010 Accepting new patients
Pinnacle Health Medical Services CurrentSince Aug 9, 2010 Accepting new patients
Pinnacle Health Medical Services Rheumatology Current Accepting new patients

Locations

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

409 S 2nd St
Ste 2F
Harrisburg, PA 17104
Phone (717) 231-8049

810 Sir Thomas Ct
#101
Harrisburg, PA 17109
Phone (717) 614-4420

3 Walnut St
Ste 100
Wormleysburg, PA 17043
Phone (717) 761-4141

Interoperability endpoints

  • Direct secure messaging: mkhan292786@upmc.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1205280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1346411824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 SIR THOMAS CT STE 101",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171094839",
            "telephone_number": "717-614-4420",
            "fax_number": "717-614-4421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 SIR THOMAS CT STE 101",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171094839",
            "telephone_number": "717-614-4420",
            "fax_number": "717-614-4421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MARIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-12",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "OH",
            "license": "57.014380",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "PA",
            "license": "MD439594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102537799",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkhan5859@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "810 Sir Thomas Ct Ste 101",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171094839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

Verify at the official NPI Registry.