Individual provider Active NPI

Muneeza Khan, M.D.

  • Family Medicine Physician
  • Memphis, TN
National Provider Identifier
1679736094
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
47720 Issued in TN
Practice address
1301 Primacy Pkwy
Memphis, TN 38119-0213
Phone
(901) 866-8812
Fax
(901) 448-0401
NPI assigned
Jul 7, 2008
Last updated
Feb 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01067420A IN
Family Medicine Physician 207Q00000X 47720 TN Primary

Addresses

Primary practice location

1301 Primacy Pkwy
Memphis, TN 38119-0213

Mailing address

1068 Cresthaven Rd Ste 300
Memphis, TN 38119-0809

Other identifiers 3

IdentifierTypeStateIssuer
1524696MedicaidTN
01120818MedicaidMS
188099001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110729000191 TN Practitioner - Family Practice 7911175344 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut Medical Group IncGroup PAC ID 3173435369, 98 clinicians

Practice addresses (Care Compare)

1301 Primacy Pkwy
Memphis, TN 38119-0213
Phone (901) 866-8528

5959 Park Ave
Memphis, TN 38119-5200
Phone (901) 765-1000

930 Madison Ave
Memphis, TN 38103-3410

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.15 of 100Reported as group
Quality
59.97
Promoting interoperability
100
Improvement activities
40
Cost
80.93

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01067420AINMDFamily Medicine Physician
47720TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Medical Group, Inc. CurrentSince Aug 1, 2011 Accepting new patients
Ut Medical Group Inc Family Medicine CurrentSince Aug 1, 2011 Accepting new patients
Amisub (SFH), Inc. Past Accepting new patients

Locations

1068 Cresthaven Rd
Ste 300
Memphis, TN 38119
Phone (901) 683-0024

1301 Primacy Pkwy
Memphis, TN 38119
Phone (901) 448-0230

1407 Union Ave
Ste 700
Memphis, TN 38104
Phone (901) 866-8360

930 Madison Ave
Ste 200
Memphis, TN 38103
Phone (901) 448-6650

Interoperability endpoints

  • Direct secure messaging: mkhan547977@direct.bmhcc.org

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

Hospital & facility affiliations 1

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": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1679736094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 CRESTHAVEN RD STE 300",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PRIMACY PKWY",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381190213",
            "telephone_number": "901-866-8812",
            "fax_number": "901-448-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MUNEEZA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-07",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01067420A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "47720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1524696",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01120818",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "188099001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.