Nafees Khan, MD

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

036096917 Issued in IL

Practice address

2512 Hurst Dr Ste 130
Mattoon, IL 61938-9200

Phone

(217) 258-5900

NPI assigned

Sep 19, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nkhan92307@direct.unitypoint.org
• Direct secure messaging: nafees.khan.1@5847.direct.athenahealth.com

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.

• Genesis Health System

  • Family Medicine Physician
  • Davenport, IA
  • NPI 1477654945

  IL

  Medicare reassignment NPD
• Genesis Health System

  • Critical Access Hospital
  • De Witt, IA
  • NPI 1649368523
  NPD
• St Luke'S Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• Franklin Pediatrics, S.C.

  • Pediatrics Physician
  • Moline, IL
  • NPI 1326188400
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1548255243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801",
            "telephone_number": "217-902-5291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 HURST DR STE 130",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619389200",
            "telephone_number": "217-258-5900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4376 7th St",
            "address_purpose": "LOCATION",
            "city": "Moline",
            "state": "IL",
            "postal_code": "612656867",
            "country_code": "US",
            "telephone_number": "309-762-0777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "NAFEES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "IL",
            "license": "036096917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00469958",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036096917",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "99106",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer A Kennedy, DDS
• Nazer Keong, PT
• Philip B. Kepp, DDS
• Olivia Keske
• Kevin Elliott Counseling, PC
• Alexandra Kiest, BS
• Andrew Kyu Hwan Kim, DC
• Andy Tuki Kim, M.D.
• Eun Ee Kim, DO
• Charles Francis Kind Jr., DPM

• Pediatric Adolescent Medicine Physician in Mattoon, IL
• Providers in Mattoon, IL by specialty
• Pediatric Adolescent Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.