Individual provider Active NPI

Khadija Haroon Chaudrey, MD

  • Gastroenterology Physician
  • Burlington, MA
National Provider Identifier
1629171913
Registry record updated Feb 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
29133 Issued in OK
Practice address
Lahey Hospital and Medical Center
41 Mall Road
Burlington, MA 01805
Phone
(781) 744-8000
NPI assigned
Sep 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 29133 OK Primary

Addresses

Primary practice location

Lahey Hospital and Medical Center
41 Mall Road
Burlington, MA 01805

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other practice location 1

200 1st St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other identifiers 1

IdentifierTypeStateIssuer
002672OtherNYLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190225000379 MA Practitioner - Gastroenterology 5991701757 Reassigns benefits to 3 organizations
I20240510000612 MD Practitioner - Gastroenterology 5991701757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians
Seacoast Affiliated Group Practice IncGroup PAC ID 1658357843, 50 clinicians

Practice addresses (Care Compare)

1 Essex Ctr Dr
Peabody, MA 01960-2901
Phone (978) 538-4000

21 Highland Ave
Newburyport, MA 01950-3873
Phone (978) 255-4217

25 Highland Ave
Newburyport, MA 01950-3867
Phone (978) 834-8074

255 Low St
Newburyport, MA 01950-3596

29 Mall Rd
Burlington, MA 01805-0001

41 Mall Rd
Burlington, MA 01805-0001

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy137
Upper gastrointestinal (GI) endoscopy for acid reflux121

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29133OKMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Seacoast Affiliated Group Practice, Inc. CurrentSince Apr 1, 2023 Accepting new patients
Upmc Western Maryland Health Services, LLC Current Accepting new patients
Lahey Clinic, Inc CurrentSince Jan 28, 2019 Accepting new patients
Lahey Clinic, Inc. CurrentSince Jan 28, 2019 Accepting new patients
Upmc Western Maryland Health Services, LLC Gastroenterology CurrentSince Jul 1, 2024 Accepting new patients
Upmc Western Maryland Health Services, LLC CurrentSince Jul 1, 2024 Accepting new patients
River Valley Infectious Disease Specialists Inc. Past Accepting new patients
Medicine Associates at Lich Past Accepting new patients

Locations

24 Morrill Pl
Amesbury, MA 01913
Phone (978) 388-5050

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

21 Highland Ave
Ste 5
Newburyport, MA 01950
Phone (978) 255-4217

12501 Willowbrook Rd
Fl 3
Cumberland, MD 21502
Phone (240) 964-8515

12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255

Interoperability endpoints

  • Direct secure messaging: kchaudrey118615@direct.bilh.masshiway.net

Organizations & group practices 8

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1629171913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LAHEY HOSPITAL AND MEDICAL CENTER",
            "address_2": "41 MALL ROAD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "01805",
            "telephone_number": "781-744-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 1st St SW",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "MN",
            "postal_code": "559050001",
            "country_code": "US",
            "telephone_number": "507-284-2511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAUDREY",
        "first_name": "KHADIJA",
        "middle_name": "HAROON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-05",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "OK",
            "license": "29133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "002672",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.