Individual provider Active NPI

Hadia Yaqub Khan, MD

  • Family Medicine Physician
  • Queen Creek, AZ
National Provider Identifier
1376267658
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
77479 Issued in AZ
Practice address
20715 E Ocotillo Rd Ste 102
Queen Creek, AZ 85142-6118
Phone
(480) 987-0987
Fax
(480) 987-0940
NPI assigned
Sep 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 77479 AZ Primary

Addresses

Primary practice location

20715 E Ocotillo Rd Ste 102
Queen Creek, AZ 85142-6118

Mailing address

PO Box 33269
Phoenix, AZ 85067-3269
Phone (602) 406-4786

Other practice location 1

3477 S Mercy Rd Ste 201
Gilbert, AZ 85297-0448
Phone (480) 728-6580

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20251021003414 AZ Practitioner - Family Practice 0345616470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sjhmc Physician ServicesGroup PAC ID 4486646197, 645 clinicians

Practice addresses (Care Compare)

20715 E Ocotillo Rd
102 DHMG Family Medicine Queen Creek
Queen Creek, AZ 85142-6118
Phone (480) 877-0901

Hospital & facility affiliations

  • Mercy Gilbert Medical Center Hospital, Gilbert, AZ, CCN 030119
  • Wellspan Good Samaritan Hospital Hospital, Lebanon, PA, CCN 390066

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
77479AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph'S Hospital and Medical Center CurrentSince Aug 30, 2020 Accepting new patients
Sjhmc Physician Services CurrentSince Nov 1, 2025 Accepting new patients
Dignity Health Past Accepting new patients

Locations

1955 W Frye Rd
Chandler, AZ 85224
Phone (480) 507-2961

3477 S Mercy Rd
Ste 201
Gilbert, AZ 85297
Phone (480) 728-6580

3555 S Val Vista Dr
Gilbert, AZ 85297
Phone (480) 434-4356

500 W Thomas Rd
Ste 680
Phoenix, AZ 85013
Phone (602) 406-6017

20715 E Ocotillo Rd
Ste 102
Queen Creek, AZ 85142
Phone (480) 877-0901

File 56765
Los Angeles, CA 90074

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1664409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786492800000",
    "number": "1376267658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33269",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850673269",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20715 E OCOTILLO RD STE 102",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851426118",
            "telephone_number": "480-987-0987",
            "fax_number": "480-987-0940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3477 S Mercy Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852970448",
            "country_code": "US",
            "telephone_number": "480-728-6580",
            "fax_number": "480-728-6581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "HADIA YAQUB",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-29",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "77479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

Verify at the official NPI Registry.