Active NPI
Khuram Mushtaq Mian, D.O.
- Neurology Physician
- Wilkes Barre, PA
National Provider Identifier
1669767885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- OS016497
- Practice address
- 1000 E Mountain Blvd
Wilkes Barre, PA 18711-0027 - Phone
- (570) 808-7300
- Fax
- (570) 808-3208
- NPI assigned
- Jun 15, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | OS016497 | PA | Primary |
Addresses
Primary practice location
1000 E Mountain Blvd
Wilkes Barre, PA 18711-0027
Mailing address
100 N Academy Ave
Danville, PA 17822-4903
Phone (570) 271-6144
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kmian232129@direct.geisinger.edu | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- New York College of Osteo Medicine of New York Institute of Technology, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1000 E Mountain Dr
Wilkes Barre, PA 18711-0027
Phone (570) 826-7300
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS016497 | PA | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Geisinger Clinic | Current | Accepting new patients | |
| Geisinger Clinic | Current | Accepting new patients | |
| Geisinger Clinic | Current | Accepting new patients |
Locations
100 N Academy Ave
Danville, PA 17822
1000 E Mountain Blvd
Wilkes Barre, PA 18711
Phone (570) 808-7399
1000 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 826-7300
Interoperability endpoints
- kmian232129@direct.geisinger.edu
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Danville, PA
- NPI 1366493868
-
- Family Medicine Physician
- Danville, PA
- NPI 1265867113
-
- Diagnostic Radiology Physician
- Danville, PA
- NPI 1558313023
Hospital & facility affiliations 20
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Diagnostic Radiology Physician
- Pittston, PA
- NPI 1104292960
Hospital
-
- General Acute Care Hospital
- Wilkes Barre, PA
- NPI 1174822068
-
- General Acute Care Hospital
- Wilkes Barre, PA
- NPI 1275620585
-
- General Acute Care Hospital
- Pittston, PA
- NPI 1316692585
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598313600000",
"number": "1669767885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N ACADEMY AVE",
"city": "DANVILLE",
"state": "PA",
"postal_code": "178224903",
"telephone_number": "570-271-6144",
"fax_number": "570-271-6578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 E MOUNTAIN BLVD",
"city": "WILKES BARRE",
"state": "PA",
"postal_code": "187110027",
"telephone_number": "570-808-7300",
"fax_number": "570-808-3208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIAN",
"first_name": "KHURAM",
"middle_name": "MUSHTAQ",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-15",
"last_updated": "2020-08-25",
"certification_date": "2020-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "PA",
"license": "OS016497",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kmian232129@direct.geisinger.edu",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1000 E Mountain Blvd",
"city": "Wilkes Barre",
"state": "PA",
"country_code": "US",
"postal_code": "187110027",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Wilkes Barre, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; 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.