Shabaz Ali Khan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

M2671 Issued in TX

Practice address

14131 Midway Rd
Suite 620
Addison, TX 75001-3623

Phone

(972) 249-0200

Fax

(972) 249-0206

NPI assigned

Oct 7, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX, MA, IL, IN4 enrollments

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 4

Specialty

Internal Medicine

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hospitalist Physicians of Massachusetts PCGroup PAC ID 4183038359, 84 clinicians

Hospitalist Physicians of Indiana PCGroup PAC ID 1052795986, 148 clinicians

Inpatient Consultants of Illinois, P.C.Group PAC ID 9537064316, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Health-la Porte Hospital, La Porte, IN, CCN 150006
• St Vincent Hospital Hospital, Worcester, MA, CCN 220176
• Osf Little Company of Mary Medical Center Hospital, Evergreen Park, IL, CCN 140179
• Northwest Health - Starke Hospital, Knox, IN, CCN 150102

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Hospitalist Physicians of Indiana, PC

  • Hospitalist Physician
  • Fort Wayne, IN
  • NPI 1306576277

  IN, Internal Medicine

  Medicare reassignment Care Compare group NPD
• Hospitalist Physicians of Massachusetts PC

  • Hospitalist Physician
  • Framingham, MA
  • NPI 1376145680

  Internal Medicine, MA

  Medicare reassignment Care Compare group NPD
• Inpatient Consultants of Illinois, P.C.

  • Hospitalist Physician
  • Hinsdale, IL
  • NPI 1548442569

  IL, Internal Medicine

  Medicare reassignment Care Compare group NPD
• Lonestar Hospital Medicine Associates, PA

  • Hospitalist Physician
  • Mansfield, TX
  • NPI 1518237429

  Internal Medicine, TX

  Medicare reassignment NPD
• Massachusetts Acute Care Specialists PC

  • Internal Medicine Physician
  • Melrose, MA
  • NPI 1306134812

  Internal Medicine, MA

  Medicare reassignment NPD
• Siripurapu Associates PLLC Medical Associates of North Texas

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1023495702

  TX

  Medicare reassignment
• Inpatient Consultants of Illinois, P.C.

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1003850843

  Internal Medicine

  NPD
• Inpatient Consultants of Illinois, P.C.

  • Hospitalist Physician
  • Hinsdale, IL
  • NPI 1609821628

  Internal Medicine

  NPD
• VHS Acquisition Subsidiary Number 7 Inc

  • General Acute Care Hospital
  • Worcester, MA
  • NPI 1538131214
  NPD (past)

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

• Knox Hospital Company LLC

  • Rural Acute Care Hospital
  • Knox, IN
  • NPI 1679948319

  Hospital

  Care Compare affiliation
• La Porte Hospital Company LLC

  • General Acute Care Hospital
  • La Porte, IN
  • NPI 1750746285

  Hospital

  Care Compare affiliation
• Osf Healthcare System

  • General Acute Care Hospital
  • Evergreen Park, IL
  • NPI 1215572045

  Hospital

  Care Compare affiliation
• VHS Acquisition Subsidiary Number 7 Inc

  • General Acute Care Hospital
  • Worcester, MA
  • NPI 1538131214

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396224000000",
    "number": "1366430076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14131 MIDWAY RD",
            "address_2": "SUITE 620",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013623",
            "telephone_number": "972-249-0200",
            "fax_number": "972-249-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14131 MIDWAY RD",
            "address_2": "SUITE 620",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013623",
            "telephone_number": "972-249-0200",
            "fax_number": "972-249-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SHABAZ",
        "middle_name": "ALI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2014-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "028345",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M2671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182315501",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8P5792",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000728714A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vijaya Kavikondala, MD
• Gloria Kaye Kendall, NP
• Elizabeth Blair Kenney, PSY.D.
• Patricia Kern-Butler, P.A.-C
• Sakina Khan
• Kidspeak, LLC
• Hyungchul Kim, D.D.S
• Kyeongmi Kim
• Leroy Kyoungman Kim, M.D.
• Michal Kimball, COTA

• All providers in Addison, TX
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2014; 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.