Individual provider Active NPI

Niloufar Khanian, MD

  • Family Medicine Physician
  • Garland, TX
National Provider Identifier
1508424516
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
T9425 Issued in TX
Practice address
4430 Lavon Dr Ste 350
Garland, TX 75040
Phone
(972) 530-8590
NPI assigned
Jun 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X T9425 TX Primary

Addresses

Primary practice location

4430 Lavon Dr Ste 350
Garland, TX 75040

Mailing address

4430 Lavon Dr Ste 350
Garland, TX 75040-2976
Phone (972) 530-8590

Other practice location 1

300 E 6th St
Texarkana, AR 71854-5207
Phone (870) 779-6000

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
I20221107002308 TX Practitioner - Family Practice 9032541412 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MedhealthGroup PAC ID 9931001567, 435 clinicians

Practice addresses (Care Compare)

4430 Lavon Dr
Suite 350
Garland, TX 75040-2976
Phone (972) 530-8590

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
T9425TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medhealth Family Medicine CurrentSince Oct 16, 2022 Accepting new patients
Medhealth CurrentSince Dec 1, 2022 Accepting new patients

Locations

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

4430 Lavon Dr
Ste 350
Garland, TX 75040
Phone (972) 530-8590

5224 S State Highway 360
Grand Prairie, TX 75052
Phone (972) 522-0691

Interoperability endpoints

  • Direct secure messaging: nkhanian192787@dm.mhd.com

Organizations & group practices 3

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 1

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": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1508424516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4430 LAVON DR STE 350",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750402976",
            "telephone_number": "972-530-8590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4430 LAVON DR STE 350",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "75040",
            "telephone_number": "972-530-8590"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 E 6th St",
            "address_purpose": "LOCATION",
            "city": "Texarkana",
            "state": "AR",
            "postal_code": "718545207",
            "country_code": "US",
            "telephone_number": "870-779-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHANIAN",
        "first_name": "NILOUFAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "T9425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garland, TX

Sources for this page

Verify at the official NPI Registry.