Individual provider Active NPI

Maung Maung Khin, M.D.

  • Critical Access Hospital
  • Modesto, CA
National Provider Identifier
1427342963
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
A115675 Issued in CA
Practice address
4601 Dale Rd
4TH Floor
Modesto, CA 95356-9718
Phone
(209) 735-4582
NPI assigned
Jun 1, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X A115675 CA Primary

Addresses

Primary practice location

4601 Dale Rd
4TH Floor
Modesto, CA 95356-9718

Mailing address

2712 Prosperity Way
Modesto, CA 95355-8647
Phone (650) 773-7638

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20111109000608 CA Practitioner - Internal Medicine 4587837448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

1721 W Yosemite Ave
Manteca, CA 95337-5130
Phone (209) 825-3700

1777 W Yosemite Ave
Manteca, CA 95337-5130
Phone (209) 825-3700

1779 W Yosemite Ave
Manteca, CA 95337-5130
Phone (209) 825-3700

1789 W Yosemite Ave
Manteca, CA 95337-5130
Phone (209) 825-3700

4601 Dale Rd
Modesto, CA 95356-9718
Phone (209) 735-5000

7373 W Lane
Stockton, CA 95210-3377
Phone (209) 476-2000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A115675CAMDCritical Access Hospital

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group Inc CurrentSince Sep 28, 2011 Accepting new patients
Permanente Medical Group, Inc CurrentSince Sep 28, 2011 Accepting new patients

Locations

4601 Dale Rd
Modesto, CA 95356
Phone (209) 557-1000

4601 Dale Rd
Fl 4
Modesto, CA 95356
Phone (209) 735-4100

1800 Harrison St
Fl 7
Oakland, CA 94612

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1427342963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2712 PROSPERITY WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953558647",
            "telephone_number": "650-773-7638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 DALE RD",
            "address_2": "4TH FLOOR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569718",
            "telephone_number": "209-735-4582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHIN",
        "first_name": "MAUNG",
        "middle_name": "MAUNG",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-01",
        "last_updated": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "CA",
            "license": "A115675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4601 Dale Road",
            "city": "Modesto",
            "state": "CA",
            "country_code": "US",
            "postal_code": "95356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.