Khaled Shams Mirza

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

C70003267 Issued in DE

Practice address

1901 N Dupont Hwy
Delaware Psychiatric Center
New Castle, DE 19720-1160

Phone

(302) 255-2700

NPI assigned

Feb 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DE

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

Psychiatry

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Uhs of Dover LLCGroup PAC ID 4486653151, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christiana Hospital Hospital, Newark, DE, CCN 080001
• Bayhealth Medical Center, Kent Campus Hospital, Dover, DE, CCN 080004

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Uhs of Dover LLC

  • Psychiatric Hospital
  • Dover, DE
  • NPI 1083708689
  Medicare reassignment Care Compare group NPD
• Suburban Psychiatric Services

  • Adult Mental Health Clinic/Center
  • Wilmington, DE
  • NPI 1770986564
  NPD (past)
• Thompson Counseling & Consulting Inc

  • Clinical Social Worker
  • New Castle, DE
  • NPI 1215052402
  NPD (past)

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

• Bayhealth Medical Center, Inc.

  • General Acute Care Hospital
  • Dover, DE
  • NPI 1467546135
  Care Compare affiliation
• Christiana Care Health Services, Inc.

  • General Acute Care Hospital
  • Wilmington, DE
  • NPI 1134194038
  Care Compare affiliation

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649318403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 N DUPONT HWY",
            "address_2": "DELAWARE PSYCHIATRIC CENTER",
            "city": "NEW CASTLE",
            "state": "DE",
            "postal_code": "197201160",
            "telephone_number": "302-255-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 N DUPONT HWY",
            "address_2": "DELAWARE PSYCHIATRIC CENTER",
            "city": "NEW CASTLE",
            "state": "DE",
            "postal_code": "197201160",
            "telephone_number": "302-255-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "KHALED",
        "middle_name": "SHAMS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "DE",
            "license": "C70003267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin A Miller
• Mindset Nutrition & Fitness
• Donna Minner, CRNA
• Minquadale Fire Co Inc
• Kimberly Kathleen Mirra, D.C.
• Christopher Ryan Mitchell, MD
• Jean Miyashiro
• Ronak Y Modi, PHARMD
• Venkat Mokkapati, MD
• Saul Montanez, RN

• Psychiatry Physician in New Castle, DE
• Providers in New Castle, DE by specialty
• Psychiatry Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.