NPIMap

Individual provider Active NPI

Mir Akbar Khan, MD

  • Internal Medicine Physician
  • Lake Charles, LA
National Provider Identifier
1669448080
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
024555 Issued in LA
Practice address
2770 3Rd Ave Ste 300
Lake Charles, LA 70601-8994
Phone
(337) 494-6800
Fax
(337) 494-4696
NPI assigned
Feb 25, 2006
Last updated
Apr 27, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 024555 LA Primary

Addresses

Primary practice location

2770 3Rd Ave Ste 300
Lake Charles, LA 70601-8994

Mailing address

PO Box 122205 Dept 2205
Dallas, TX 75312-2205
Phone (337) 494-2921

Other practice location 1

1717 Oak Park Blvd Fl 1
Lake Charles, LA 70601-8977
Phone (337) 494-6800

Other practice location 2

4345 Nelson Rd Ste 201
Lake Charles, LA 70605-4183
Phone (337) 494-6800

Other identifiers 1

IdentifierTypeStateIssuer
1573396MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20080703000379 LA Practitioner - Internal Medicine 4587665674 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of South Alabama College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swlhs LLCGroup PAC ID 6406938612, 17 clinicians
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

1701 Oak Park Blvd
Lake Charles, LA 70601-8911

1717 Oak Park Blvd
FL 1
Lake Charles, LA 70601-8977
Phone (337) 494-6800

2770 3Rd Ave
Suite 320
Lake Charles, LA 70601-8994
Phone (337) 494-6800

401 Doctor Michael Debakey Dr
Lake Charles, LA 70601-5864
Phone (337) 436-6100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
024555LAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swlhs LLC Internal Medicine CurrentSince May 19, 2008 Accepting new patients
Harbor Hospice of Lake Charles, LP Past Accepting new patients
Imperial Health LLP Past Accepting new patients
Diversified Health Care-Lake Charles, LLC Past Accepting new patients
Brighton Bridge Hospice LLC Past Accepting new patients
Imperial Health LLP Past Accepting new patients
Lake Charles Healthcare LLC Past Accepting new patients
Southwest Louisiana Hospital Association Inc Past Accepting new patients
Lake Charles Medical & Surgical Clinic Past Accepting new patients

Locations

1902 Johnson St
Jennings, LA 70546
Phone (337) 788-2864

1717 Oak Park Blvd
Fl 1
Lake Charles, LA 70601
Phone (337) 478-3810

2770 3rd Ave
Ste 300
Lake Charles, LA 70601
Phone (337) 477-6061

2770 3rd Ave
Ste 320
Lake Charles, LA 70601
Phone (337) 494-6800

4345 Nelson Rd
Fl 2
Lake Charles, LA 70605
Phone (337) 494-6800

4345 Nelson Rd
Ste 201
Lake Charles, LA 70605
Phone (337) 494-6800

Interoperability endpoints

  • Direct secure messaging: mkhan5281931@direct.casso.us.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Harbor Hospice of Lake Charles, LPLake Charles, LA, CCN 191625 Hospice 5% Or Greater Direct Ownership Interest
General Partnership Interest		 Oct 1, 2006
Oct 1, 2006

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 10

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 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1140825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1669448080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 122205 DEPT 2205",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753122205",
            "telephone_number": "337-494-2921",
            "fax_number": "337-494-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 3RD AVE STE 300",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018994",
            "telephone_number": "337-494-6800",
            "fax_number": "337-494-4696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1717 Oak Park Blvd Fl 1",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706018977",
            "country_code": "US",
            "telephone_number": "337-494-6800",
            "fax_number": "337-494-6811",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4345 Nelson Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706054183",
            "country_code": "US",
            "telephone_number": "337-494-6800",
            "fax_number": "337-494-6811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MIR",
        "middle_name": "AKBAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-25",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "024555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1573396",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.