Individual provider Active NPI

Omer Hayat Khan, M.D

  • Internal Medicine Physician
  • Salem, OR
National Provider Identifier
1679907844
Registry record updated Aug 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD177155 Issued in OR
Practice address
890 Oak St SE
Salem, OR 97301-3905
Phone
(503) 561-5200
NPI assigned
Aug 23, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2016

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 MD177155 OR Primary

Addresses

Primary practice location

890 Oak St SE
Salem, OR 97301-3905

Mailing address

1700 E 13TH St
Cleveland, OH 44114-3266
Phone (216) 704-9609

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20160825000128 OR Practitioner - HospitalistPractitioner - Internal Medicine 0749575074 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salem HealthGroup PAC ID 8628986668, 470 clinicians

Practice addresses (Care Compare)

890 Oak St SE
Salem, OR 97301-3905
Phone (503) 561-5200

Hospital & facility affiliations

  • Salem Hospital Hospital, Salem, OR, CCN 380051

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Health CurrentSince Aug 22, 2016 Accepting new patients
Salem Health CurrentSince Aug 22, 2016 Accepting new patients
Salem Health West Valley CurrentSince Aug 22, 2016 Accepting new patients

Locations

525 SE Washington St
Dallas, OR 97338
Phone (503) 623-7344

1601 Monmouth St
Ste 100
Independence, OR 97351
Phone (503) 623-8301

875 Oak St SE
Salem, OR 97301
Phone (503) 561-5719

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

890 Oak St SE
Salem, OR 97301
Phone (503) 585-0830

1049 Edgewater St NW
#150
Salem, OR 97304
Phone (503) 814-3343

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.

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": "1377216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471305600000",
    "number": "1679907844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 E 13TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441143266",
            "telephone_number": "216-704-9609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 OAK ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973013905",
            "telephone_number": "503-561-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "OMER",
        "middle_name": "HAYAT",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-23",
        "last_updated": "2016-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD177155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.