NPIMap

Individual provider Active NPI

Mazen Khalil, M.D.

  • Hematology & Oncology Physician
  • Jonesboro, AR
National Provider Identifier
1659323608
Registry record updated Oct 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
E-5722 Issued in AR
Practice address
300 Carson St
Jonesboro, AR 72401-3104
Phone
(870) 932-5296
Fax
(870) 910-7713
NPI assigned
May 17, 2006
Last updated
Oct 24, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 40968 TN
Hematology & Oncology Physician 207RH0003X E-5722 AR Primary

Addresses

Primary practice location

300 Carson St
Jonesboro, AR 72401-3104

Mailing address

300 Carson St
Jonesboro, AR 72401-3104
Phone (870) 932-5296

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20081017000349 AR Practitioner - Internal MedicinePractitioner - Hematology/Oncology 5799798542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hematology/Oncology
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cancer Care Associates IncGroup PAC ID 2769637222, 23 clinicians

Practice addresses (Care Compare)

225 E Jackson Ave
Jonesboro, AR 72401-3119
Phone (870) 207-8210

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
61.2 of 100Reported as individual
Quality
67.6
Improvement activities
40
Cost
10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40968TNMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cancer Care Associates Inc Hematology & Oncology CurrentSince May 1, 2017 Accepting new patients
Wahid Hanna MD PC Hematology & Oncology Past Accepting new patients

Locations

225 E Jackson Ave
Jonesboro, AR 72401
Phone (870) 207-1630

Organizations & group practices 2

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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224806400000",
    "number": "1659323608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CARSON ST",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013104",
            "telephone_number": "870-932-5296",
            "fax_number": "870-910-7713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CARSON ST",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013104",
            "telephone_number": "870-932-5296",
            "fax_number": "870-910-7713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIL",
        "first_name": "MAZEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2008-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TN",
            "license": "40968",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "AR",
            "license": "E-5722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.