Ilyas Mohammed Khan, M.D

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

Q1680 Issued in TX

Practice address

209 Gaslight Blvd
Lufkin, TX 75904-3134

Phone

(936) 632-8787

NPI assigned

Sep 26, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

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

Specialty

Cardiovascular Disease (Cardiology)

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baylor St. Luke'S Medical GroupGroup PAC ID 9133213192, 172 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI St Lukes Health Memorial Lufkin Hospital, Lufkin, TX, CCN 450211
• Woodland Heights Medical Center Hospital, Lufkin, TX, CCN 450484
• Nacogdoches Memorial Hospital Hospital, Nacogdoches, TX, CCN 450508
• Nacogdoches Medical Center Hospital, Nacogdoches, TX, CCN 450656
• CHI St Lukes Health Memorial San Augustine Hospital, San Augustine, TX, CCN 670783

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JIHBCA
• Direct secure messaging: i.mohammed@direct.hiet.nextgenshare.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.

• Baylor St. Luke'S Medical Group

  • Internal Medicine Physician
  • The Woodlands, TX
  • NPI 1740485879

  Cardiovascular Disease

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Memorial Health System of East Texas

  • Rural Acute Care Hospital
  • Lufkin, TX
  • NPI 1396746129
  Care Compare affiliation
• Memorial Medical Center San Augustine

  • Rural Acute Care Hospital
  • San Augustine, TX
  • NPI 1578547345
  Care Compare affiliation
• Nacogdoches County Hospital District

  • Rural Acute Care Hospital
  • Nacogdoches, TX
  • NPI 1801831748
  Care Compare affiliation
• Piney Woods Healthcare System, L.P.

  • General Acute Care Hospital
  • Lufkin, TX
  • NPI 1487607792
  Care Compare affiliation
• TH Healthcare, LTD

  • General Acute Care Hospital
  • Nacogdoches, TX
  • NPI 1700885076
  Care Compare affiliation

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

{
    "created_epoch": "1253923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1598099327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 GASLIGHT BLVD",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043133",
            "telephone_number": "936-632-8787",
            "fax_number": "936-632-8832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 GASLIGHT BLVD",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043134",
            "telephone_number": "936-632-8787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 S John Redditt Dr",
            "address_purpose": "LOCATION",
            "city": "Lufkin",
            "state": "TX",
            "postal_code": "759043120",
            "country_code": "US",
            "telephone_number": "936-632-8787",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "904 W Columbia St",
            "address_purpose": "LOCATION",
            "city": "San Augustine",
            "state": "TX",
            "postal_code": "759721715",
            "country_code": "US",
            "telephone_number": "936-632-8787",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1105 W Frank Ave",
            "address_purpose": "LOCATION",
            "city": "Lufkin",
            "state": "TX",
            "postal_code": "759043303",
            "country_code": "US",
            "telephone_number": "936-632-8787",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "233 Hurst St",
            "address_purpose": "LOCATION",
            "city": "Center",
            "state": "TX",
            "postal_code": "759354321",
            "country_code": "US",
            "telephone_number": "936-632-8787",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "310 Gaslight Blvd",
            "address_purpose": "LOCATION",
            "city": "Lufkin",
            "state": "TX",
            "postal_code": "759043133",
            "country_code": "US",
            "telephone_number": "936-632-8787",
            "fax_number": "936-632-8832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "ILYAS",
        "middle_name": "MOHAMMED",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-26",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "274581",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "Q1680",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "Q1680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03828824",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "341967301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane Marie Ketterling
• Kevin Dixon DO PA
• Kevin W Farris M.D., P.a.
• Sondra Louise Khalil, M.D.
• Ghazala B Khan, MD
• Mohammed Musa Khan, M.D.
• Wasim Mhammad Khan, MD
• Hazel Darleen Kimbrough, FNP
• Kindrell S. Tucker, MD, PA
• Ashland King

• Cardiovascular Disease Physician in Lufkin, TX
• Providers in Lufkin, TX by specialty
• Cardiovascular Disease Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.