Individual provider Active NPI

Mateen Khokhar

  • Hospitalist Physician
  • Phoenix, AZ
National Provider Identifier
1447788930
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
008469 Issued in AZ
Practice address
350 W Thomas Rd
Phoenix, AZ 85013-4409
Phone
(602) 406-5590
Fax
(602) 406-7170
NPI assigned
May 26, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R2825 AZ
Hospitalist Physician 208M00000X 008469 AZ Primary

Addresses

Primary practice location

350 W Thomas Rd
Phoenix, AZ 85013-4409

Mailing address

PO Box 33269
Phoenix, AZ 85067-3269
Phone (602) 406-4786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20200519001411 AZ Practitioner - Internal Medicine 7012272040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Arizona College of Osteopathic Medicine Mid Western University, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sjhmc Physician ServicesGroup PAC ID 4486646197, 645 clinicians

Practice addresses (Care Compare)

500 W Thomas Rd
680 DHMG St Joseph'S Pelvic Pain and Surg
Phoenix, AZ 85013-4235
Phone (602) 406-6017

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008469AZMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sjhmc Physician Services CurrentSince Oct 1, 2021 Accepting new patients
St. Joseph'S Hospital and Medical Center CurrentSince Aug 30, 2020 Accepting new patients
Dignity Health Past Accepting new patients

Locations

500 W Thomas Rd
Ste 680
Phoenix, AZ 85013
Phone (602) 406-6017

3030 N Central Ave
Ste 1001
Phoenix, AZ 85012

350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001

File 56765
Los Angeles, CA 90074

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": "1495756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1447788930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33269",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850673269",
            "telephone_number": "602-406-4786",
            "fax_number": "916-636-4358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134409",
            "telephone_number": "602-406-5590",
            "fax_number": "602-406-7170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOKHAR",
        "first_name": "MATEEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-26",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "R2825",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "008469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.