Individual provider Active NPI

Razib Khaund, MD

  • Sports Medicine (Internal Medicine) Physician
  • Providence, RI
National Provider Identifier
1497733547
Registry record updated Jun 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X
License
MD08864 Issued in RI
Practice address
100 Butler Dr
Providence, RI 02906-4862
Phone
(401) 330-1415
NPI assigned
Jan 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Internal Medicine) Physician 207RS0010X MD08864 RI Primary

Addresses

Primary practice location

100 Butler Dr
Providence, RI 02906-4862

Mailing address

PO Box 1119
Providence, RI 02901-1119
Phone (401) 330-1415

Other identifiers 4

IdentifierTypeStateIssuer
23279-9OtherRIBCBS RI
005317OtherRIBLUECHIP
691762OtherRIHPHC
7004729MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20040518000470 RI Practitioner - Internal MedicinePractitioner - Sports Medicine 4183614316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Sports Medicine
Education
Rutgers New Jersey Medical School, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affinity Physicians LLC.Group PAC ID 0244413391, 723 clinicians

Practice addresses (Care Compare)

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010

Hospital & facility affiliations

  • Kent County Memorial Hospital Hospital, Warwick, RI, CCN 410009

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD08864RIMDSports Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC. CurrentSince Feb 1, 2015 Accepting new patients
Affinity Physicians LLC CurrentSince Feb 1, 2015 Accepting new patients

Locations

1405 S County Trl
Ste 510
East Greenwich, RI 02818
Phone (401) 736-4523

1539 Atwood Ave
Ste 203
Johnston, RI 02919
Phone (401) 421-2110

111 Brewster St
Pawtucket, RI 02860
Phone (401) 729-2000

100 Butler Dr
Providence, RI 02906
Phone (401) 277-0790

593 Eddy St
Providence, RI 02903

2 Dudley St
Ste 200
Providence, RI 02905
Phone (401) 457-1504

345 Blackstone Blvd
Providence, RI 02906
Phone (401) 455-6375

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Interoperability endpoints

  • Direct secure messaging: rkhaund@direct.carene.org

Organizations & group practices 2

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": "1136678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401753600000",
    "number": "1497733547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1119",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029011119",
            "telephone_number": "401-330-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BUTLER DR",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064862",
            "telephone_number": "401-330-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAUND",
        "first_name": "RAZIB",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-08",
        "last_updated": "2014-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "RI",
            "license": "MD08864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS RI",
            "identifier": "23279-9",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECHIP",
            "identifier": "005317",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "691762",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7004729",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.