NPIMap

Individual provider Active NPI

Agha Baber Khan

  • Endocrinology, Diabetes & Metabolism Physician
  • Pueblo, CO
National Provider Identifier
1649336546
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
DR37853 Issued in CO
Practice address
1303 Fortino Blvd Ste a
Pueblo, CO 81008-2032
Phone
(719) 544-0052
NPI assigned
Dec 28, 2006
Last updated
Oct 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X DR37853 CO Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 28422 AZ

Addresses

Primary practice location

1303 Fortino Blvd Ste a
Pueblo, CO 81008-2032

Mailing address

PO Box 8090
Pueblo, CO 81008-8090
Phone (719) 544-0052

Other practice location 1

300 Singleton Ridge Rd
Conway, SC 29526-9142
Phone (843) 347-7111

Other practice location 2

500 W Thomas Rd Ste 900B
Phoenix, AZ 85013-4223
Phone (602) 406-3300

Other identifiers 1

IdentifierTypeStateIssuer
70773874MedicaidCO

Other names 1

  • Agha Baber Khan Professional name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address endopueblo@outlook.com
Direct Messaging Address endopueblo@outlook.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, AZ2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110215000391 CO Practitioner - Endocrinology 1254301484 Reassigns benefits to 1 organization
I20221021001064 AZ Practitioner - Endocrinology 1254301484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sjhmc Physician ServicesGroup PAC ID 4486646197, 645 clinicians

Practice addresses (Care Compare)

1303 Fortino Blvd
Suite a
Pueblo, CO 81008-2032
Phone (719) 544-0052

500 W Thomas Rd
Suite 900B
Phoenix, AZ 85013-4224
Phone (602) 406-2323

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28422AZMDEndocrinology, Diabetes & Metabolism Physician
DR37853COMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph's Hospital and Medical Center Single Specialty CurrentSince Aug 30, 2020 Accepting new patients
Sjhmc Physician Services Single Specialty CurrentSince Oct 1, 2022 Accepting new patients
Agha Baber Khan MD PA Single Specialty Past Accepting new patients
Inphynet Contracting Services LLC Single Specialty Past Accepting new patients
Preferred Medical Plan Single Specialty Past Accepting new patients
East West Medical Center Inc Single Specialty Past Accepting new patients
Inpatient Consultants of Colorado, PC Single Specialty Past Accepting new patients

Locations

500 W Thomas Rd
Ste 680
Phoenix, AZ 85013
Phone (602) 406-6017

500 W Thomas Rd
Ste 900B
Phoenix, AZ 85013
Phone (602) 406-2323

File 56765
Los Angeles, CA 90074

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1649336546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8090",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810088090",
            "telephone_number": "719-544-0052",
            "fax_number": "719-545-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 FORTINO BLVD STE A",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082032",
            "telephone_number": "719-544-0052"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Singleton Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "SC",
            "postal_code": "295269142",
            "country_code": "US",
            "telephone_number": "843-347-7111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 W Thomas Rd Ste 900B",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850134223",
            "country_code": "US",
            "telephone_number": "602-406-3300",
            "fax_number": "602-406-4272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "AGHA",
        "middle_name": "BABER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CO",
            "license": "DR37853",
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "AZ",
            "license": "28422",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70773874",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "endopueblo@outlook.com",
            "affiliation": "N",
            "address_1": "1303 Fortino Blvd Ste A",
            "city": "Pueblo",
            "state": "CO",
            "country_code": "US",
            "postal_code": "810082032",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "endopueblo@outlook.com",
            "affiliation": "N",
            "address_1": "1303 Fortino Blvd Ste A",
            "city": "Pueblo",
            "state": "CO",
            "country_code": "US",
            "postal_code": "810082032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "AGHA",
            "last_name": "KHAN",
            "middle_name": "BABER",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.