Organization Active NPI

Muhammad Y Khan MD SC

  • Vascular Surgery Physician
  • Milwaukee, WI
National Provider Identifier
1558429282
Registry record updated Jun 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
MUHAMMAD Y KHAN MD SC
Practice address
1218 W Kilbourn Ave
Ste 409
Milwaukee, WI 53233
Phone
(414) 271-1900
Fax
(414) 271-8087
NPI assigned
Dec 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2014

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

Authorized official

Name
Muahmmad Yousaf Khan, MD SC
Title
Owner
Phone
(414) 271-1900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

1218 W Kilbourn Ave
Ste 409
Milwaukee, WI 53233

Mailing address

1218 W Kilbourn Ave
#409
Milwaukee, WI 53233-1330
Phone (414) 271-1900

Other identifiers 1

IdentifierTypeStateIssuer
30887200MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100220000394 WI Part B Supplier - Clinic/Group Practice 6608910237 Receives reassigned benefits from 1 practitioner
Practice locations: Milwaukee, WI

National Provider Directory

National Provider Directory

Locations

1218 W Kilbourn Ave
Ste 409
Milwaukee, WI 53233
Phone (414) 271-1900

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403049600000",
    "number": "1558429282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 W KILBOURN AVE",
            "address_2": "#409",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331330",
            "telephone_number": "414-271-1900",
            "fax_number": "414-271-8087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 W KILBOURN AVE",
            "address_2": "STE 409",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53233",
            "telephone_number": "414-271-1900",
            "fax_number": "414-271-8087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUHAMMAD Y KHAN MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2014-06-18",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "MUAHMMAD",
        "authorized_official_middle_name": "YOUSAF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "414-271-1900",
        "authorized_official_credential": "MD SC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30887200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.