Individual provider Active NPI

Khatija Zahiruddin, DO

  • Emergency Medicine Physician
  • York, PA
National Provider Identifier
1447546759
Registry record updated Dec 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS019413 Issued in PA
Practice address
1001 S George St
York, PA 17403
Phone
(717) 851-1405
Fax
(717) 851-6969
NPI assigned
Jun 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS019413 PA Primary
Emergency Medicine Physician 207P00000X 257448 MA

Addresses

Primary practice location

1001 S George St
York, PA 17403

Mailing address

3421 Concord Rd
York, PA 17402-9001
Phone (717) 851-1405

Other practice location 1

1001 S George St
York, PA 17403
Phone (717) 851-1405

Other practice location 2

55 Lake Ave N
Emergency Medicine
Worcester, MA 01655-0002
Phone (508) 421-1400

Other practice location 3

1001 S George St
York, PA 17403
Phone (717) 851-1405

Other identifiers 1

IdentifierTypeStateIssuer
110102494AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, PA2 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

Enrollment IDStateProvider typePAC IDDetails
I20160829000938 NY Practitioner - Emergency Medicine 3072827138 Reassigns benefits to 1 organization
I20181108001270 PA Practitioner - Emergency Medicine 3072827138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
York HospitalGroup PAC ID 2961307467, 94 clinicians

Practice addresses (Care Compare)

1001 S George St
York, PA 17403-3676
Phone (717) 851-2345

Hospital & facility affiliations

  • Wellspan York Hospital Hospital, York, PA, CCN 390046

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
257448MAMDEmergency Medicine Physician
OS019413PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
York Hospital Current Accepting new patients
York Hospital CurrentSince Sep 24, 2018 Accepting new patients
Emergency Care Services of New York, P.C. Emergency Medicine CurrentSince Jul 1, 2016 Accepting new patients

Locations

321 Genesee St
Oneida, NY 13421
Phone (315) 361-2020

605 S George St
Ste 200
York, PA 17401
Phone (717) 851-2334

1001 S George St
York, PA 17403
Phone (717) 812-7687

Interoperability endpoints

  • Direct secure messaging: kzahiruddin140152@wellspan.direct-ci.com

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.

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": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544572800000",
    "number": "1447546759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174029001",
            "telephone_number": "717-851-1405",
            "fax_number": "717-851-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S GEORGE ST",
            "city": "YORK",
            "state": "PA",
            "postal_code": "17403",
            "telephone_number": "717-851-1405",
            "fax_number": "717-851-6969"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 S George St",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "17403",
            "country_code": "US",
            "telephone_number": "717-851-1405",
            "fax_number": "717-851-6969",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Lake Ave N",
            "address_2": "Emergency Medicine",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "508-421-1400",
            "fax_number": "508-421-1490",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 S George St",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "17403",
            "country_code": "US",
            "telephone_number": "717-851-1405",
            "fax_number": "717-851-6969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAHIRUDDIN",
        "first_name": "KHATIJA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-24",
        "last_updated": "2018-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OS019413",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "257448",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110102494A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

Verify at the official NPI Registry.