Individual provider Active NPI

Waqas Khan, MD

  • Pediatrics Physician
  • Bedford, IN
National Provider Identifier
1407592728
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
01095506A Issued in IN
Practice address
1614 25TH St
Bedford, IN 47421-5000
Phone
(812) 277-0118
NPI assigned
May 10, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01095506A IN Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1614 25TH St
Bedford, IN 47421-5000

Mailing address

2201 Hempstead Tpke
East Meadow, NY 11554-1859
Phone (516) 572-6177

Other practice location 1

2201 Hempstead Turnpike, East Meadow
East Meadow, NY 11554
Phone (516) 572-6177

Other practice location 2

2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone (317) 948-2700

Other identifiers 2

IdentifierTypeStateIssuer
1105177877OtherINANTHEM
300113388MedicaidIN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address wkhan@direct.iuhealth.org Direct
Direct Messaging Address wkhan@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20250522002930 IN Practitioner - Pediatric Medicine 7315466372 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01095506AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Southern Indiana Physicians LLC CurrentSince Jul 1, 2025 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jan 1, 2026 Accepting new patients
Indiana University Health Southern Indiana Physicians, LLC CurrentSince Jul 1, 2025 Accepting new patients

Locations

1614 25th St
Bedford, IN 47421
Phone (812) 277-0118

2651 E Discovery Pkwy
Bloomington, IN 47408
Phone (812) 353-9147

727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

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.

NPI Registry JSON

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

{
    "created_epoch": "1652140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1407592728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 HEMPSTEAD TPKE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115541859",
            "telephone_number": "516-572-6177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1614 25TH ST",
            "city": "BEDFORD",
            "state": "IN",
            "postal_code": "474215000",
            "telephone_number": "812-277-0118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 Hempstead Turnpike, East Meadow",
            "address_purpose": "LOCATION",
            "city": "East Meadow",
            "state": "NY",
            "postal_code": "11554",
            "country_code": "US",
            "telephone_number": "516-572-6177",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2651 E Discovery Pkwy",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474089059",
            "country_code": "US",
            "telephone_number": "317-948-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "WAQAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-10",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01095506A",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "1105177877",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300113388",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wkhan@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2651 E Discovery Pkwy",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474089059",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wkhan@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1614 25th St",
            "city": "Bedford",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474215000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bedford, IN

Sources for this page

Verify at the official NPI Registry.