Khizar Ali, M.D.
Individual provider Active NPI Anesthesiology Physician · Indianapolis, IN
NPI 1487920823 · NPPES record last updated Aug 26, 2016
Key facts
- NPI
- 1487920823
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 01075583 (IN)
- Practice address
- 8111 S Emerson Ave
Indianapolis, IN 46237-8601 - Phone
- (317) 528-3447
- NPI assigned
- Mar 30, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 15
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Anesthesiology
- Education
- Indiana University School of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cep America - Anesthesia PC
Premier Anesthesia of California PC
Practice addresses (Care Compare)
2000 Mowry Ave
Fremont, CA 94538-1716
Phone (510) 797-1111
2405 Shadelands Dr
Suite 200
Walnut Creek, CA 94598-5916
Phone (925) 935-6700
825 Delbon Ave
Turlock, CA 95382-2016
Phone (404) 941-1210
Hospital & facility affiliations
- San Ramon Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IN, CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160809000482 | IN | Practitioner - Anesthesiology | 0244465078 | Reassigns benefits to 1 organization |
| I20171115002237 | CA | Practitioner - Anesthesiology | 0244465078 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01075583 | IN | MD | Anesthesiology Physician |
| 125.061955 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Anesthesiologists, Inc. | Anesthesiology | Current |
Accepting new patients |
| John Muir Trauma Physicians Billing Service | Anesthesiology | Current |
Accepting new patients |
| Cep America - Anesthesia PC | Anesthesiology | Current |
Accepting new patients |
| Premier Anesthesia of California, PC | Anesthesiology | Current |
Accepting new patients |
| Cep America - Anesthesia PC | Anesthesiology | Current |
Accepting new patients |
| Cep America - Anesthesia, PC | Anesthesiology | Current | Accepting new patients |
| John Muir Trauma Physicians Billing Service | Current | Accepting new patients | |
| Cep America - Anesthesia PC | Anesthesiology | Past | Accepting new patients |
| Major Hospital | Past | Accepting new patients |
Locations
2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638
2000 Mowry Ave
Fremont, CA 94538
Phone (510) 793-6653
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
825 Delbon Ave
Turlock, CA 95382
Phone (209) 664-2744
2405 Shadelands Dr
Ste 200
Walnut Creek, CA 94598
Phone (615) 234-5924
1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545
1601 Ygnacio Valley Rd
#100
Walnut Creek, CA 94598
Phone (925) 947-5245
8111 S Emerson Ave
Indianapolis, IN 46237
Phone (317) 528-5261
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 01075583 | IN | Yes |
| Internal Medicine Physician | 207R00000X | 125.061955 | IL |
Addresses
Primary practice location
8111 S Emerson Ave
Indianapolis, IN 46237-8601
Mailing address
1775 Ballard Rd
Park Ridge, IL 60068-1005
Phone (847) 318-9340
Other providers in Indianapolis, IN
- Andrea Ali
- Asima Nuzhat Ali
- Hamza Ali
- Haroon M Ali
- Iyad Ali
- Mahek Rashid Ali
- Mahmoud Ahmed Youssef Ali
- Meganh Ali
- Mir I Ali
- Murtaza Ali
All providers in Indianapolis, IN · Anesthesiology Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.