Individual provider Active NPI

Faisal Khatri, M.D.

  • Internal Medicine Physician
  • Mason, OH
National Provider Identifier
1588066922
Registry record updated Oct 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.134977 Issued in OH
Practice address
4859 Nixon Park Dr Ste a
Mason, OH 45040-8106
Phone
(513) 492-5940
Fax
(513) 492-5941
NPI assigned
Sep 17, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R3242 KY
Family Medicine Physician 207Q00000X 01077614A IN
Internal Medicine Physician 207R00000X 35.134977 OH Primary

Addresses

Primary practice location

4859 Nixon Park Dr Ste a
Mason, OH 45040-8106

Mailing address

3170 Kettering Blvd BLDG B3
Moraine, OH 45439-1924
Phone (937) 991-3186

Other practice location 1

5 Matchett Dr
Pierceton, IN 46562-9073
Phone (574) 594-2136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20181101003200 OH Practitioner - Family Practice 7719265552 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mvhe Inc Internal Medicine CurrentSince Sep 18, 2018 Accepting new patients
Mvhe Inc Family Medicine CurrentSince Sep 18, 2018 Accepting new patients

Locations

2451 Wayne Ave
Dayton, OH 45420
Phone (937) 252-1831

4859 Nixon Park Dr
Ste A
Mason, OH 45040
Phone (513) 492-5940

3170 Kettering Blvd
Bldg B
Moraine, OH 45439
Phone (937) 991-3187

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1588066922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3170 KETTERING BLVD BLDG B3",
            "city": "MORAINE",
            "state": "OH",
            "postal_code": "454391924",
            "telephone_number": "937-991-3186",
            "fax_number": "937-223-9811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4859 NIXON PARK DR STE A",
            "city": "MASON",
            "state": "OH",
            "postal_code": "450408106",
            "telephone_number": "513-492-5940",
            "fax_number": "513-492-5941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Matchett Dr",
            "address_purpose": "LOCATION",
            "city": "Pierceton",
            "state": "IN",
            "postal_code": "465629073",
            "country_code": "US",
            "telephone_number": "574-594-2136",
            "fax_number": "574-594-2281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHATRI",
        "first_name": "FAISAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-17",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "R3242",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01077614A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.134977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

Verify at the official NPI Registry.