NPIMap

Individual provider Active NPI

Sirajabid Khatib, MD

  • Internal Medicine Physician
  • Marion, IN
National Provider Identifier
1396737524
Registry record updated Dec 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
01050026A Issued in IN
Practice address
441 N Wabash Ave
Marion, IN 46952-2612
Phone
(765) 662-4236
Fax
(765) 662-4903
NPI assigned
Aug 15, 2005
Last updated
Dec 26, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01050026A IN Primary
Hospitalist Physician 208M00000X 01050026A IN

Addresses

Primary practice location

441 N Wabash Ave
Marion, IN 46952-2612

Mailing address

330 N Wabash
Suite G20
Marion, IN 46952-2600
Phone (765) 660-7600

Other identifiers 2

IdentifierTypeStateIssuer
200375870MedicaidIN
000001150856OtherINANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040202000060 IN Practitioner - HospitalistPractitioner - Internal Medicine 0244133692 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marion General HospitalGroup PAC ID 9133023625, 115 clinicians

Practice addresses (Care Compare)

441 N Wabash Ave
Marion, IN 46952-2612
Phone (765) 660-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.82 of 100Reported as group
Quality
71.45
Promoting interoperability
100
Improvement activities
40
Cost
75.59

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sound Physicians of Indiana, LLC Internal Medicine CurrentSince Jul 1, 2016 Accepting new patients
Marion General Hospital Internal Medicine CurrentSince Feb 14, 2018 Accepting new patients
Sound Physicians of Indiana, LLC Internal Medicine CurrentSince Jul 1, 2016 Accepting new patients
Marion General Hospital CurrentSince Feb 14, 2018 Accepting new patients
Hancock Physician Network, LLC Internal Medicine PastSince Jun 20, 2003 Accepting new patients

Locations

4781 Kaybee Dr
Gas City, IN 46933
Phone (765) 660-7840

330 N Wabash Ave
Ste G-20
Marion, IN 46952
Phone (765) 660-7600

441 N Wabash Ave
Marion, IN 46952
Phone (219) 482-4577

5215 Holy Cross Pkwy
Mishawaka, IN 46545
Phone (574) 335-2443

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Marion General HospitalMarion, IN, CCN 15T011 Hospital Corporate Director Jul 1, 2019
Marion General HospitalMarion, IN, CCN 150011 Hospital Corporate Director Jul 1, 2019

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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 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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577318400000",
    "number": "1396737524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N WABASH",
            "address_2": "SUITE G20",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522600",
            "telephone_number": "765-660-7600",
            "fax_number": "765-651-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 N WABASH AVE",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469522612",
            "telephone_number": "765-662-4236",
            "fax_number": "765-662-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHATIB",
        "first_name": "SIRAJABID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2019-12-26",
        "certification_date": "2019-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01050026A",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IN",
            "license": "01050026A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200375870",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000001150856",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IN

Sources for this page

Verify at the official NPI Registry.