Kulsoom A Khan, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

042.0013685 Issued in VT

Practice address

49 School Street
Hartford, VT 05047-0709

Phone

(802) 295-3031

Fax

(802) 295-0820

NPI assigned

Feb 6, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Dr. Kulsoom Alvi Khan Other name

Medicare fee-for-service enrollment

Enrolled in CA, VT2 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

Specialty

Psychiatry

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Health Care and Rehabilitation Services of Southeastern Vermont IncGroup PAC ID 4183698830, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Brattleboro Memorial Hospital Hospital, Brattleboro, VT, CCN 470011
• Springfield Hospital Hospital, Springfield, VT, CCN 471306

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Health Care and Rehabilitation Services of Southeastern Vermont, Inc.

  • Community/Behavioral Health Agency
  • Springfield, VT
  • NPI 1790861342
  Medicare reassignment Care Compare group NPD
• County of Santa Clara

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • San Jose, CA
  • NPI 1699885079
  Medicare reassignment NPD
• County of Santa Clara

  • Psychiatry Physician
  • San Jose, CA
  • NPI 1932313582
  Medicare reassignment NPD
• Health Care and Rehabilitation Services of Southeastern Vermont, Inc.

  • Community/Behavioral Health Agency
  • Bellows Falls, VT
  • NPI 1396962742
  NPD
• County of Santa Clara

  • Anesthesiology Physician
  • San Jose, CA
  • NPI 1588721500
  NPD
• County of Santa Clara

  • Pharmacy
  • San Jose, CA
  • NPI 1891871919
  NPD
• Unmc Physicians

  • Multi-Specialty Clinic/Center
  • Omaha, NE
  • NPI 1417912114
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Brattleboro Memorial Hospital

  • General Acute Care Hospital
  • Brattleboro, VT
  • NPI 1306849708
  Care Compare affiliation
• Springfield Hospital

  • Critical Access Hospital Clinic/Center
  • Springfield, VT
  • NPI 1033225875
  Care Compare affiliation

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1396884151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 RIVER ST",
            "city": "SPRINGFIELD",
            "state": "VT",
            "postal_code": "051562226",
            "telephone_number": "802-886-4500",
            "fax_number": "802-886-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 SCHOOL STREET",
            "city": "HARTFORD",
            "state": "VT",
            "postal_code": "050470709",
            "telephone_number": "802-295-3031",
            "fax_number": "802-295-0820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "KULSOOM",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "C52915",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VT",
            "license": "042.0013685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029599",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KULSOOM",
            "last_name": "KHAN",
            "middle_name": "ALVI",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Charlene Hjermstad
• Rachel Hobart, BA
• Hildegard Hyde, MA, LCMHC, LADC
• Elisabeth P. Keith, MA MFT LMFT
• Christina Lynne Key, MSW LCSW LICSW
• Elizabeth B. Kooperkamp, PHD
• Kathy J. Lane, MA
• Christine Lowery, MA
• Lynn M. McCormick, MD
• Kelly McGee

• Psychiatry Physician in Hartford, VT
• Providers in Hartford, VT by specialty
• Psychiatry Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.