Individual provider Active NPI

Khalid Walid Shaqdan, MB BCH BAO

  • Diagnostic Radiology Physician
  • Richmond, VA
National Provider Identifier
1629630678
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
0101270289 Issued in VA
Practice address
1250 E Marshall St FL 3
Richmond, VA 23298-5023
Phone
(804) 828-3151
NPI assigned
Jun 30, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 0101270289 VA Primary

Addresses

Primary practice location

1250 E Marshall St FL 3
Richmond, VA 23298-5023

Mailing address

1250 E Marshall St
Richmond, VA 23298-5023
Phone (804) 828-3151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20240912000499 VA Practitioner - Diagnostic Radiology 2062747637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCV Associated PhysiciansGroup PAC ID 4385542117, 1,779 clinicians

Practice addresses (Care Compare)

1250 E Marshall St
Richmond, VA 23219-5051
Phone (804) 828-9000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.95 of 100Reported as group
Quality
69.91
Promoting interoperability
99
Improvement activities
40
Cost
77.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101270289VAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MCV Associated Physicians Diagnostic Radiology CurrentSince Jul 1, 2024 Accepting new patients

Locations

1250 E Marshall St
Richmond, VA 23298
Phone (804) 628-6990

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

1250 E Marshall St
Fl 3
Richmond, VA 23298
Phone (804) 828-3151

618 Hospital Rd
Tappahannock, VA 22560
Phone (804) 443-3311

Organizations & group practices 1

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 3

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": "1561852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1629630678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 E MARSHALL ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985023",
            "telephone_number": "804-828-3151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E MARSHALL ST FL 3",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985023",
            "telephone_number": "804-828-3151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAQDAN",
        "first_name": "KHALID",
        "middle_name": "WALID",
        "name_prefix": "Dr.",
        "credential": "MB BCH BAO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-30",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101270289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.