Individual provider Active NPI

Mahboob Ali Khan, MD

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1508834599
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
Q4160 Issued in TX
Practice address
3571 W Wheatland Rd
Ste 101
Dallas, TX 75237-3461
Phone
(972) 274-5555
Fax
(972) 274-5563
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD426847 PA
Internal Medicine Physician 207R00000X 28163 AL
Nephrology Physician 207RN0300X Q4160 TX
Hospitalist Physician 208M00000X 35.095158 OH
Hospitalist Physician 208M00000X MD426847 PA
Internal Medicine Physician 207R00000X Q4160 TX Primary

Addresses

Primary practice location

3571 W Wheatland Rd
Ste 101
Dallas, TX 75237-3461

Mailing address

3571 W Wheatland Rd
Ste 101
Dallas, TX 75237-3461
Phone (972) 274-5555

Other identifiers 12

IdentifierTypeStateIssuer
051541255OtherALBLUE CROSS
819381OtherPAFIRST PRIORITY HEALTH
051541252OtherALBLUE CROSS
009910049MedicaidAL
009910051MedicaidAL
I38194OtherPAHEALTHAMERICA
P00244719OtherPARAILROAD MEDICARE
1751916OtherPAHIGHMARK BLUE SHIELD
009910050MedicaidAL
101349604MedicaidPA
051541253OtherALBLUE CROSS
7711714OtherPAAETNA

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
I20150716001574 TX Practitioner - Internal MedicinePractitioner - Nephrology 3274564356 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dallas Renal Group, P.a.Group PAC ID 0244277283, 52 clinicians
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians
Lonestar Hospital Medicine Associates PAGroup PAC ID 6709049703, 126 clinicians

Practice addresses (Care Compare)

1222 N Bishop Ave
Suite 500
Dallas, TX 75208-1478
Phone (972) 274-5555

1300 W Terrell Ave
Suite K230
Fort Worth, TX 76104-3104
Phone (817) 250-7240

2400 N I
35E Baylor Scott and White
Waxahachie, TX 75165
Phone (469) 843-4280

2700 E Broad St
Mansfield, TX 76063-5899
Phone (682) 622-2000

7999 W Virginia Dr
Suite a
Dallas, TX 75237-3845
Phone (888) 616-6322

Hospital & facility affiliations

  • Usrc Premier Waxahachie Dialysis facility, Waxahachie, TX, CCN 672668
  • USRC Premier Midlothian Dialysis facility, Midlothian, TX, CCN 742746
  • Methodist Midlothian Medical Center Hospital, Midlothian, TX, CCN 670300
  • Baylor Scott & White Medical Center- Waxahachie Hospital, Waxahachie, TX, CCN 450372
  • Methodist Mansfield Medical Center Hospital, Mansfield, TX, CCN 670023
  • Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135
  • Ennis Regional Medical Center Hospital, Ennis, TX, CCN 450833

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
28163ALMDInternal Medicine Physician
35.095158OHMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group Current Accepting new patients
Dallas Renal Group PA Nephrology CurrentSince Jul 2, 2015 Accepting new patients
Healthtexas Provider Network Internal Medicine Current Accepting new patients
Lonestar Hospital Medicine Associates, PA Internal Medicine CurrentSince Dec 1, 2015 Accepting new patients
Healthtexas Provider Network Internal Medicine CurrentSince Sep 13, 2021 Accepting new patients
Texas Health Physicians Group CurrentSince Mar 1, 2023 Accepting new patients
Texas Health Physicians Group Internal Medicine CurrentSince Mar 1, 2023 Accepting new patients
Healthtexas Provider Network CurrentSince Sep 13, 2021 Accepting new patients
Usrc Cedar Hill, LLC PastSince Aug 30, 2016 Accepting new patients
Methodist Hospitals of Dallas Past Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500

3571 W Wheatland Rd
#101
Dallas, TX 75237
Phone (972) 274-5555

1222 N Bishop Ave
Ste 500
Dallas, TX 75208
Phone (972) 274-5555

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

1300 W Terrell Ave
Ste K230
Fort Worth, TX 76104
Phone (817) 250-7240

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

1201 E Highway 287
Midlothian, TX 76065
Phone (469) 695-2065

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

341 Wheatfield Dr
Ste 100
Sunnyvale, TX 75182
Phone (972) 329-1996

2400 N Interstate Highway 35 E
Waxahachie, TX 75165
Phone (469) 843-4000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HEHCAD
  • Direct secure messaging: mahboob.khan@drg.eclinicaldirectplus.com
  • Direct secure messaging: mkhan710256@direct.texashealth.org
  • Direct secure messaging: mkhan444917@direct.sw.org

Organizations & group practices 11

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 7

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1508834599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3571 W WHEATLAND RD",
            "address_2": "STE 101",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752373461",
            "telephone_number": "972-274-5555",
            "fax_number": "972-274-5563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3571 W WHEATLAND RD",
            "address_2": "STE 101",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752373461",
            "telephone_number": "972-274-5555",
            "fax_number": "972-274-5563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MAHBOOB",
        "middle_name": "ALI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD426847",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "28163",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TX",
            "license": "Q4160",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OH",
            "license": "35.095158",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD426847",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q4160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "051541255",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST PRIORITY HEALTH",
            "identifier": "819381",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "051541252",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009910049",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009910051",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHAMERICA",
            "identifier": "I38194",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00244719",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "1751916",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009910050",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101349604",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "051541253",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7711714",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.