Moid Khan, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

130228 Issued in NY

Practice address

531 Washington St
Ste 2401
Watertown, NY 13601-4069

Phone

(315) 788-3070

Fax

(315) 788-8061

NPI assigned

Oct 12, 2006

Last updated

Mar 31, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1417046038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "531 WASHINGTON ST",
            "address_2": "STE 2401",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136014069",
            "telephone_number": "315-788-3070",
            "fax_number": "315-788-8061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 WASHINGTON ST",
            "address_2": "STE 2401",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136014069",
            "telephone_number": "315-788-3070",
            "fax_number": "315-788-8061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MOID",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "130228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Secret Angel Kennedy
• Abbey Frances Kerr, PA-C
• Rebecca Keshmiri, D.C.
• Cindy Kessler, LPN
• Kevin W. Deeney, DDS, PC
• Sadaqat Khan, M.D.
• Ludwig E Khoury, MD
• Theresa L Kiefer
• Robert O Kimball, M.D.
• William Humphrey Kimball, PH.D.

• Family Medicine Physician in Watertown, NY
• Providers in Watertown, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.