Individual provider Active NPI

Ansab Khwaja, MD PC

  • Orthopaedic Surgery Physician
  • Longview, WA
National Provider Identifier
1366896797
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
FK1223750 Issued in WA
Practice address
625 9TH Ave Ste 210
Longview, WA 98632-2465
Phone
(360) 501-3400
Fax
(360) 423-5682
NPI assigned
Apr 21, 2016
Last updated
Mar 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X FK1223750 WA Primary

Addresses

Primary practice location

625 9TH Ave Ste 210
Longview, WA 98632-2465

Mailing address

625 9TH Ave Ste 210
Longview, WA 98632-2465
Phone (360) 501-3400

Other identifiers 1

IdentifierTypeStateIssuer
1366896797MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20230818001998 OR Practitioner - Orthopedic Surgery 8022308568 Reassigns benefits to 1 organization
I20250429003799 WA Practitioner - Orthopedic Surgery 8022308568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Washington School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Longview Orthopedic Associates PLLCGroup PAC ID 7315976792, 11 clinicians

Practice addresses (Care Compare)

625 9TH Ave
Suite 210
Longview, WA 98632-2465
Phone (360) 501-3400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement13
Knee replacement23
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
FK1223750WAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Longview Orthopedic Associates, PLLC Orthopaedic Surgery CurrentSince Apr 1, 2025 Accepting new patients
Ansab Khwaja MD PC Orthopaedic Surgery CurrentSince Sep 1, 2023 Accepting new patients
Eastside Orthopedics & Sports Medicine, LLC Orthopaedic Surgery CurrentSince Oct 1, 2024 Accepting new patients

Locations

25050 SE Stark St
Ste 301
Gresham, OR 97030
Phone (503) 659-1769

6542 SE Lake Rd
Ste 201
Portland, OR 97222
Phone (503) 659-1769

625 9th Ave
Ste 210
Longview, WA 98632
Phone (360) 501-3400

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 3

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": "1461196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1366896797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 9TH AVE STE 210",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322465",
            "telephone_number": "360-501-3400",
            "fax_number": "360-423-5682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 9TH AVE STE 210",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322465",
            "telephone_number": "360-501-3400",
            "fax_number": "360-423-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHWAJA",
        "first_name": "ANSAB",
        "credential": "MD PC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-21",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "FK1223750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366896797",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

Verify at the official NPI Registry.