Ejaz M Khan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D0092421 Issued in MD

Practice address

20 Watkins Park Dr
Upper Marlboro, MD 20774-1628

Phone

(301) 350-8500

Fax

(540) 350-8503

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in VA, MD, DC3 enrollments

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 3

Specialty

Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)

Education

New York Medical College, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mary Washington Hospital IncGroup PAC ID 0446143820, 53 clinicians

Stafford Hospital, LLCGroup PAC ID 3779650262, 6 clinicians

Mary Washington Healthcare Providers LLCGroup PAC ID 1456629369, 264 clinicians

Icarenow LLCGroup PAC ID 1355717042, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mary Washington Hospital Hospital, Fredericksburg, VA, CCN 490022
• Stafford Hospital, LLC Hospital, Stafford, VA, CCN 490140

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ekhan65582@marywashingtonhealthcare.direct-ci.com
• FHIR API: https://fhir4.healow.com/fhir/r4/DFHEAD

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.

• Icarenow LLC

  • Family Medicine Physician
  • Upper Marlboro, MD
  • NPI 1245967033

  DC, Internal Medicine

  Medicare reassignment Care Compare group NPD Authorized official
• Mary Washington Healthcare Providers LLC

  • Hospitalist Physician
  • Fredericksburg, VA
  • NPI 1750826277

  Cardiovascular Disease

  Medicare reassignment Care Compare group NPD
• Mary Washington Hospital, Inc.

  • Cardiovascular Disease Physician
  • Fredericksburg, VA
  • NPI 1013089879
  Medicare reassignment Care Compare group NPD
• Stafford Hospital, LLC

  • General Practice Physician
  • Stafford, VA
  • NPI 1750714440

  Cardiovascular Disease

  Medicare reassignment Care Compare group NPD
• Mary Washington Healthcare Physicians

  • Family Medicine Physician
  • Fredericksburg, VA
  • NPI 1295999852
  Medicare reassignment NPD
• Oracle Heart & Vascular, Inc.

  • Interventional Cardiology Physician
  • Fredericksburg, VA
  • NPI 1972924520

  Cardiovascular Disease

  Medicare reassignment NPD
• Winchester Medical Center

  • Critical Care Medicine (Internal Medicine) Physician
  • Winchester, VA
  • NPI 1679711261
  Medicare reassignment NPD
• Icarenow LLC

  • General Practice Physician
  • Upper Marlboro, MD
  • NPI 1538364898
  NPD (past) Authorized official
• Icarenow, LLC

  • Primary Care Clinic/Center
  • Upper Marlboro, MD
  • NPI 1083581060
  NPD (past) Authorized official
• Mary Washington Healthcare Physicians

  • Durable Medical Equipment & Medical Supplies
  • Fredericksburg, VA
  • NPI 1740853035
  NPD
• Mary Washington Hospital Inc.

  • General Acute Care Hospital
  • Fredericksburg, VA
  • NPI 1942288527
  NPD
• Pathology Associates of Fredericksburg PTR

  • Anatomic Pathology Physician
  • Fredericksburg, VA
  • NPI 1033150982
  NPD

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

• Mary Washington Hospital Inc.

  • General Acute Care Hospital
  • Fredericksburg, VA
  • NPI 1942288527
  Care Compare affiliation
• Mary Washington Hospital, Inc.

  • Cardiovascular Disease Physician
  • Fredericksburg, VA
  • NPI 1013089879

  Hospital

  Care Compare affiliation
• Mary Washington Hospital, Inc.

  • Home Health Agency
  • Fredericksburg, VA
  • NPI 1407814163

  Hospital

  Care Compare affiliation
• Stafford Hospital, LLC

  • General Acute Care Hospital
  • Stafford, VA
  • NPI 1043343304
  Care Compare affiliation

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1669416160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 WATKINS PARK DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207741628",
            "telephone_number": "301-350-8500",
            "fax_number": "540-350-8503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 WATKINS PARK DR",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207741628",
            "telephone_number": "301-350-8500",
            "fax_number": "540-350-8503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "EJAZ",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "VA",
            "license": "0101239751",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NJ",
            "license": "25MA09948900",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0092421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810010077",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669416160",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alex B Kengne Tatsinkam
• Kennedy Family Medicine
• Nathan Kennedy, DC
• Laponda Kersey
• Aysha Khan, M.D.
• Usman Tariq Khan, M.D.
• Kymia Khosrowani, MD
• Myoung Woon Kim
• Caryl Denise King Grant, CCC-SLP
• Barrington King

• Internal Medicine Physician in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; 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.