NPIMap

Individual provider Active NPI

Shaan Khan, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • La Porte, IN
National Provider Identifier
1629488002
Registry record updated Jun 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
01082263A Issued in IN
Practice address
500 Legacy PLZ W
La Porte, IN 46350-5254
Phone
(219) 326-1234
NPI assigned
May 6, 2014
Last updated
Jun 2, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pain Medicine (Anesthesiology) Physician 207LP2900X 01082263A IN Primary

Addresses

Primary practice location

500 Legacy PLZ W
La Porte, IN 46350-5254

Mailing address

7528 Perrier Dr
Indianapolis, IN 46278-1647
Phone (317) 828-1900

Other practice location 1

750 E Adams St
Syracuse, NY 13210-2306
Phone (317) 828-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190823000243 IN Practitioner - Pain ManagementPractitioner - Anesthesiology 8123365723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chesterton Physical Therapy IncGroup PAC ID 3173683984, 191 clinicians

Practice addresses (Care Compare)

3212 Hickory Rd
Suite B
Mishawaka, IN 46545-8863
Phone (574) 251-0498

425 Sand Creek Dr
Suite C
Chesterton, IN 46304-1589

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01082263AINMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Pain & Anesthesia Consultants, PC Single Specialty CurrentSince Jan 1, 2021 Accepting new patients
Advance Pain & Anesthesia Consultants, PC Single Specialty CurrentSince Jan 1, 2021 Accepting new patients
Michiana Surgery Center, LLC Current Accepting new patients

Locations

11456 Broadway
Crown Point, IN 46307
Phone (219) 488-0154

425 US Highway 30
Ste 400
Dyer, IN 46311
Phone (219) 488-0165

307 W Johnson Rd
Ste C
La Porte, IN 46350
Phone (219) 575-7578

500 Legacy Plz W
Laporte, IN 46350
Phone (219) 326-0943

3212 Hickory Rd
Ste A
Mishawaka, IN 46545
Phone (574) 251-0498

3212 Hickory Rd
Ste B
Mishawaka, IN 46545
Phone (574) 251-0498

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1399334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559433600000",
    "number": "1629488002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7528 PERRIER DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462781647",
            "telephone_number": "317-828-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LEGACY PLZ W",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463505254",
            "telephone_number": "219-326-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 E Adams St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132102306",
            "country_code": "US",
            "telephone_number": "317-828-1900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SHAAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-06",
        "last_updated": "2019-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IN",
            "license": "01082263A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Porte, IN

Sources for this page

Verify at the official NPI Registry.