Individual provider Active NPI

Madiha Ahmed Khan, M.D.

  • Family Medicine Physician
  • Webster, TX
National Provider Identifier
1497015689
Registry record updated Dec 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
Q5005 Issued in TX
Practice address
1408 W Nasa Pkwy Ste a
Webster, TX 77598-1649
Phone
(832) 412-7166
Fax
(512) 713-0797
NPI assigned
May 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Q5005 TX Primary

Addresses

Primary practice location

1408 W Nasa Pkwy Ste a
Webster, TX 77598-1649

Mailing address

1408 W Nasa Pkwy Ste a
Webster, TX 77598-1649
Phone (832) 412-7166

Other practice location 1

301 University Blvd
Galveston, TX 77555-1395
Phone (281) 614-1256

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150814014087 TX Practitioner - Family Practice 8628383999 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Utmb Faculty Group PracticeGroup PAC ID 3375456734, 1,083 clinicians

Practice addresses (Care Compare)

2785 Gulf Fwy S
Suite 165
League City, TX 77573-4990
Phone (832) 505-0139

301 University Blvd
Galveston, TX 77555-5302
Phone (409) 772-2222

PO Box
650859 Dept 710
Dallas, TX 75265-0859

Hospital & facility affiliations

  • University of Texas Medical Branch Galveston Hospital, Galveston, TX, CCN 450018
  • HCA Houston Healthcare Clear Lake Hospital, Webster, TX, CCN 450617

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q5005TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utmb Faculty Group Practice CurrentSince Jul 7, 2015 Accepting new patients

Locations

301 University Blvd
Galveston, TX 77555
Phone (409) 747-1883

2785 Gulf Fwy S
Ste 165
League City, TX 77573
Phone (832) 505-0139

Interoperability endpoints

  • Direct secure messaging: madiha.khan.1@21938.direct.athenahealth.com

Organizations & group practices 1

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 2

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": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609027200000",
    "number": "1497015689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 W NASA PKWY STE A",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775981649",
            "telephone_number": "832-412-7166",
            "fax_number": "512-713-0797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 W NASA PKWY STE A",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775981649",
            "telephone_number": "832-412-7166",
            "fax_number": "512-713-0797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 University Blvd",
            "address_purpose": "LOCATION",
            "city": "Galveston",
            "state": "TX",
            "postal_code": "775551395",
            "country_code": "US",
            "telephone_number": "281-614-1256",
            "fax_number": "281-614-1587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MADIHA",
        "middle_name": "AHMED",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-21",
        "last_updated": "2020-12-27",
        "certification_date": "2020-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q5005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Webster, TX

Sources for this page

Verify at the official NPI Registry.