Farah Mehdi Khatoon, DO

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

02006332A Issued in IN

Practice address

100 Navarre PL Ste 5570
South Bend, IN 46601-1169

Phone

(574) 647-2550

NPI assigned

Jan 28, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Texas Children'S Physician Group

  • Pediatrics Physician
  • Houston, TX
  • NPI 1861675506
  Medicare reassignment NPD
• Pinnacle Health Medical Services

  • Gastroenterology Physician
  • Mechanicsburg, PA
  • NPI 1295552073
  NPD
• Pinnacle Health Medical Services

  • Professional Counselor
  • Harrisburg, PA
  • NPI 1861069791
  NPD
• Pinnacle Health Medical Services

  • Family Medicine Physician
  • Harrisburg, PA
  • NPI 1932143427
  NPD
• Central Georiga Fertility Institute

  • Reproductive Endocrinology Physician
  • Macon, GA
  • NPI 1447390901
  NPD (past)
• Health Services of Central Georgia, Inc

  • Multi-Specialty Clinic/Center
  • Macon, GA
  • NPI 1184679482

  Pediatric Endocrinology

  NPD (past)
• Lurie Children'S Medical Group, LLC

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1992758544
  NPD (past)
• Texas Children'S Hospital

  • Children's Hospital
  • Austin, TX
  • NPI 1194507947
  NPD (past)

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1639356108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NAVARRE PL STE 5570",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011169",
            "telephone_number": "574-647-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHATOON",
        "first_name": "FARAH",
        "middle_name": "MEHDI",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-28",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "TX",
            "license": "S2367",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "IL",
            "license": "036126725",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "GA",
            "license": "56304",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "IN",
            "license": "02006332A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA LICENCE",
            "identifier": "56304",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD",
            "identifier": "S2367",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300049227",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Unk",
            "affiliation": "N",
            "address_1": "8611 N Mopac Expy",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "787598319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sedra Jo Ketcham, APRN
• Thomas R. Keucher, M.D.
• Evelin Keultjes, NP
• Walid Khabbaz, M.D.
• Harmanjot Singh Khaira, MD
• Stephen M Kiai, APRN
• Kids for Life Physical Therapy Inc.
• Jennifer Ann Kieninger, COTA
• Justine Kil
• Kathleen M Kilbury

• Pediatric Endocrinology Physician in South Bend, IN
• Providers in South Bend, IN by specialty
• Pediatric Endocrinology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.