Individual provider Active NPI

Hidayat Khan, M.D.

  • Allergy Physician
  • Frederick, MD
National Provider Identifier
1386619583
Registry record updated Nov 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
D0023240 Issued in MD
Practice address
801 Toll House Ave
Frederick, MD 21701-4564
Phone
(301) 694-4935
Fax
(301) 694-0389
NPI assigned
Feb 21, 2006
Last updated
Nov 29, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X D0023240 MD Primary

Addresses

Primary practice location

801 Toll House Ave
Frederick, MD 21701-4564

Mailing address

4221 Buckskin Wood Dr
Ellicott City, MD 21042-1217
Phone (301) 694-4935

Other identifiers 1

IdentifierTypeStateIssuer
K347OtherMDBLUECROSS BLUESHIELD OF M

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20120417000326 MD Practitioner - Allergy/Immunology 3375643679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 1967
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Asthma and Allergy Center LLCGroup PAC ID 7719909639, 35 clinicians

Practice addresses (Care Compare)

1050 N Point Rd
Suite 201
Baltimore, MD 21224-3336
Phone (410) 282-2903

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Asthma & Allergy Center LLC CurrentSince Sep 3, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1050 Northpoint Rd
Ste 201
Baltimore, MD 21224
Phone (410) 282-2903

208 Plumtree Rd
Ste B
Bel Air, MD 21015
Phone (410) 638-1999

10802 Hickory Ridge Rd
Columbia, MD 21044
Phone (410) 964-3888

14995 Shady Grove Rd
Ste 100
Rockville, MD 20850
Phone (301) 869-7820

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.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322524800000",
    "number": "1386619583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4221 BUCKSKIN WOOD DR",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210421217",
            "telephone_number": "301-694-4935",
            "fax_number": "301-694-0389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 TOLL HOUSE AVE",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014564",
            "telephone_number": "301-694-4935",
            "fax_number": "301-694-0389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "HIDAYAT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2011-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "MD",
            "license": "D0023240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD OF M",
            "identifier": "K347",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.