Khansa Ali

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Great Falls, MT

NPI 1497632277 · NPPES record last updated Aug 21, 2025

Key facts

NPI
1497632277
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
License
MED-RES-LIC-159294 (MT)
Practice address
1101 26TH St S
Great Falls, MT 59405-5161
Phone
(407) 771-6300
NPI assigned
Aug 21, 2025
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20250925000551 MT Order and Referring Only - Internal Medicine
Practitioner - Internal Medicine
6406351949

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
MED-RES-LIC-159294MTMDStudent in an Organized Health Care Education/Training Program

Interoperability endpoints

  • Direct secure messaging: kali55558@benefishs.direct-ci.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MED-RES-LIC-159294 MT Yes

Addresses

Primary practice location

1101 26TH St S
Great Falls, MT 59405-5161

Mailing address

1101 26TH St S
Great Falls, MT 59405-5161
Phone (407) 771-6300

Other providers in Great Falls, MT

All providers in Great Falls, MT · Student in an Organized Health Care Education/Training Program in Montana

Sources for this page

Verify at the official NPI Registry.