Individual provider Active NPI

Khadija L Ahmed, M.D.

  • Internal Medicine Physician
  • Springfield, OH
National Provider Identifier
1366567265
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35-094335 Issued in OH
Practice address
2100 Emmanuel Way Ste B
Springfield, OH 45502-7218
Phone
(937) 504-0120
Fax
(937) 521-1092
NPI assigned
Mar 20, 2007
Last updated
Dec 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35-094335 OH Primary

Addresses

Primary practice location

2100 Emmanuel Way Ste B
Springfield, OH 45502-7218

Mailing address

1 Prestige PL Ste 550
Miamisburg, OH 45342-6115
Phone (937) 762-1310

Other names 1

  • Khadija L Faridi Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kahmed550866@direct.ketteringhealth.org
FHIR URL https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20110105000521 OH Practitioner - Internal Medicine 9335338441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alliance Physicians IncGroup PAC ID 0840104360, 314 clinicians

Practice addresses (Care Compare)

1625 S Alex Rd
West Carrollton, OH 45449-5404
Phone (937) 865-0534

2300 N Limestone St
Suite 120
Springfield, OH 45503-1102
Phone (937) 504-8390

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.8 of 100Reported as group
Quality
73.21
Promoting interoperability
100
Improvement activities
40
Cost
76.12

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physicians, Inc. CurrentSince Oct 1, 2021 Accepting new patients
Alliance Physicians Inc Internal Medicine CurrentSince Oct 1, 2021 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Queens Long Island Medical Group, P.C. Internal Medicine Past Accepting new patients

Locations

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 762-1306

2115 Leiter Rd
Miamisburg, OH 45342
Phone (937) 384-6920

2100 Emmanuel Way
Ste B
Springfield, OH 45502
Phone (937) 398-0020

2300 N Limestone St
Ste 120
Springfield, OH 45503
Phone (866) 224-9472

2300 N Limestone St
Ste 230
Springfield, OH 45503

1625 S Alex Rd
West Carrollton, OH 45449
Phone (937) 865-0534

386 N Detroit St
Xenia, OH 45385
Phone (937) 352-2860

Interoperability endpoints

  • Direct secure messaging: kahmed550866@direct.ketteringhealth.org

Organizations & group practices 4

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 6

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1366567265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PRESTIGE PL STE 550",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453426115",
            "telephone_number": "937-762-1310",
            "fax_number": "937-522-8006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 EMMANUEL WAY STE B",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455027218",
            "telephone_number": "937-504-0120",
            "fax_number": "937-521-1092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "KHADIJA",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35-094335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kahmed550866@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "2100 Emmanuel Way Ste B",
            "city": "Springfield",
            "state": "OH",
            "country_code": "US",
            "postal_code": "455027218",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https:/khnarr.ketthealth.com/FHIR-PROD/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "2100 Emmanuel Way Ste B",
            "city": "Springfield",
            "state": "OH",
            "country_code": "US",
            "postal_code": "455027218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KHADIJA",
            "last_name": "FARIDI",
            "middle_name": "L",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, OH

Sources for this page

Verify at the official NPI Registry.