Individual provider Active NPI

Khulkar Mirzozoda, MD, MBA

  • Interventional Cardiology Physician
  • Philadelphia, PA
National Provider Identifier
1487144309
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MD474832 Issued in PA
Practice address
833 Chestnut St Ste 220
Philadelphia, PA 19107
Phone
(215) 955-8465
Fax
(215) 955-2516
NPI assigned
May 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X MD474832 PA Primary

Addresses

Primary practice location

833 Chestnut St Ste 220
Philadelphia, PA 19107

Mailing address

44 S Washington Ave
Greensburg, PA 15601-2768
Phone (724) 836-1862

Other practice location 1

44 S Washington Ave
Greensburg, PA 15601-2768
Phone (724) 836-1862

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20210909000090 PA Practitioner - General Surgery 7214292705 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Associates in Healthcare, Inc. CurrentSince Jul 8, 2021 Accepting new patients
Methodist Associates in Healthcare, Inc CurrentSince Jul 8, 2021 Accepting new patients
Methodist Associates in Healthcare, Inc Internal Medicine Current Accepting new patients

Locations

2301 S Broad St
Ste 102
Philadelphia, PA 19148
Phone (215) 952-5175

2301 S Broad St
Philadelphia, PA 19148
Phone (215) 952-9000

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.

NPI Registry JSON

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

{
    "created_epoch": "1526428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1487144309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 S WASHINGTON AVE",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156012768",
            "telephone_number": "724-836-1862",
            "fax_number": "724-689-0543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST STE 220",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19107",
            "telephone_number": "215-955-8465",
            "fax_number": "215-955-2516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44 S Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Greensburg",
            "state": "PA",
            "postal_code": "156012768",
            "country_code": "US",
            "telephone_number": "724-836-1862",
            "fax_number": "724-689-0543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRZOZODA",
        "first_name": "KHULKAR",
        "name_prefix": "Dr.",
        "credential": "MD, MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-16",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "PA",
            "license": "MD474832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.