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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250925000551 | MT | Order and Referring Only - Internal Medicine |
6406351949 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MED-RES-LIC-159294 | MT | MD | Student in an Organized Health Care Education/Training Program |
Interoperability endpoints
- kali55558@benefishs.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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- Kevin Cedric Allen
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All providers in Great Falls, MT · Student in an Organized Health Care Education/Training Program in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2025. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.