Individual provider Active NPI

Mohammad Shahid A Khan, MD

  • Internal Medicine Physician
  • Colton, CA
National Provider Identifier
1477589257
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A81486 Issued in CA
Practice address
400 N Pepper Ave
Colton, CA 92324-1801
Phone
(909) 580-1000
NPI assigned
Jun 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A81486 CA Primary

Addresses

Primary practice location

400 N Pepper Ave
Colton, CA 92324-1801

Mailing address

PO Box 998
North Hollywood, CA 91603-0998
Phone (818) 509-2222

Other identifiers 1

IdentifierTypeStateIssuer
00A814860MedicaidCA

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
I20040413001853 CA Practitioner - Addiction MedicinePractitioner - Internal MedicinePractitioner - Psychiatry 7012901895 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A81486CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Monterey CurrentSince Dec 1, 2006 Accepting new patients
County of Monterey Behavioral Health CurrentSince Dec 1, 2006 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jul 1, 2008 Accepting new patients
Clinic Services of California Medical Group Inc CurrentSince Aug 1, 2018 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jul 1, 2008 Accepting new patients
Quantum Healthcare Medical Associates Inc. Internal Medicine CurrentSince Oct 8, 2014 Accepting new patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Primary Critical Care Limited Partnership Internal Medicine PastSince Jan 1, 1990 Accepting new patients
Loma Linda University Children'S Hospital Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients
Faculty Physicians and Surgeons of Llusm Past Accepting new patients
Primary Critical Care Limited Partnership Internal Medicine PastSince Jan 1, 1990 Accepting new patients

Locations

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800

8851 Center Dr
Ste 600
La Mesa, CA 91942
Phone (619) 589-0785

1235 W Vine St
Ste 20
Lodi, CA 95240
Phone (209) 339-7600

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

26520 Cactus Ave
Moreno Valley, CA 92555
Phone (951) 486-5610

400 N McDowell Blvd
Petaluma, CA 94954
Phone (707) 778-1111

1686 Barton Rd
Ste 2100
Redlands, CA 92373

1710 Barton Rd
Redlands, CA 92373
Phone (909) 558-9200

1686 Barton Rd
Redlands, CA 92373
Phone (909) 558-9200

1686 Barton Rd
#2100
Redlands, CA 92373

1450 Medical Center Dr
Rohnert Park, CA 94928
Phone (707) 546-3210

1441 Constitution Blvd
Salinas, CA 93906
Phone (831) 261-8090

Interoperability endpoints

  • Direct secure messaging: mkhan8258@direct.llu.edu

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204070400000",
    "number": "1477589257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 998",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916030998",
            "telephone_number": "818-509-2222",
            "fax_number": "818-509-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MOHAMMAD SHAHID",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2008-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A81486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A814860",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.