Komal Gulab Khattak

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00772700 Issued in NJ

Practice address

3B, 186 Princeton Hightstown Rd
#104
West Windsor Township, NJ 08550

Phone

(609) 799-8444

NPI assigned

Sep 4, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Comprehensive Pain Center

  • Pain Medicine (Anesthesiology) Physician
  • New Brunswick, NJ
  • NPI 1205298692

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599177600000",
    "number": "1548874605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 FEATHERBED LN",
            "city": "AUDUBON",
            "state": "PA",
            "postal_code": "194032055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3B, 186 PRINCETON HIGHTSTOWN RD",
            "address_2": "#104",
            "city": "WEST WINDSOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "08550",
            "telephone_number": "609-799-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHATTAK",
        "first_name": "KOMAL",
        "middle_name": "GULAB",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-04",
        "last_updated": "2020-09-04",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00772700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "PayDC",
            "affiliation": "N",
            "address_1": "3B, 186 Princeton Hightstown Rd",
            "address_2": "#104",
            "city": "West Windsor Township",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "08550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Charles M. Cummins, OD, PA
• Luxottica of America Inc.

• Chiropractor in West Windsor Township, NJ
• Providers in West Windsor Township, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.