Individual provider Active NPI

Abdur Rahman Khan, M.D.

  • Interventional Cardiology Physician
  • Boston, MA
National Provider Identifier
1700132750
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
036170870 Issued in IL
Practice address
Massachusetts General Hospital
55 Fruit Street
Boston, MA 02114
Phone
(617) 643-3238
NPI assigned
Jul 27, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 036170870 IL Primary
Cardiovascular Disease Physician 207RC0000X 12584A WY
Cardiovascular Disease Physician 207RC0000X 21278 ND
Interventional Cardiology Physician 207RI0011X 278659 MA
Interventional Cardiology Physician 207RI0011X 12584A WY

Addresses

Primary practice location

Massachusetts General Hospital
55 Fruit Street
Boston, MA 02114

Mailing address

PO Box 20970
Cheyenne, WY 82003-7020
Phone (307) 637-1600

Other practice location 1

6810 State Route 162 Ste 102
Maryville, IL 62062-8560
Phone (618) 288-4076

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address akhan42437@direct.crmcwy.org Health Information Exchange (HIE) Memorial Hospital of Laramie County
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)
Direct Messaging Address akhan42437@direct.crmcwy.org Direct Memorial Hospital of Laramie County

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WY, IL, MO, TX4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20200616001349 WY Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 5092043489 Reassigns benefits to 3 organizations
I20240917003359 IL Practitioner - Interventional Cardiology 5092043489 Reassigns benefits to 1 organization
I20241205000830 MO Practitioner - Interventional Cardiology 5092043489 Reassigns benefits to 1 organization
I20241211000587 TX Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 5092043489 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians
Rajiv Agarwal MD PAGroup PAC ID 6305184011, 21 clinicians
Cheyenne Regional Physicians Group LLCGroup PAC ID 2961403639, 101 clinicians

Practice addresses (Care Compare)

1 Memorial Dr
Alton, IL 62002-6722
Phone (618) 463-7240

11133 Dunn Rd
Saint Louis, MO 63136-6163
Phone (314) 653-5643

11155 Dunn Rd
Suite 109N
Saint Louis, MO 63136-6148
Phone (314) 953-8799

18835 McKay Dr
Humble, TX 77338-5721
Phone (832) 644-8930

2301 House Ave
Suite 301
Cheyenne, WY 82001-3178
Phone (307) 637-1600

4116 Laramie St
Cheyenne, WY 82001-1969
Phone (307) 635-7961

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21278NDMDCardiovascular Disease Physician
12584AWYMDCardiovascular Disease Physician
036170870ILMDInterventional Cardiology Physician
278659MAMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rajiv Agarwal MD PA Cardiovascular Disease CurrentSince Feb 6, 2025 Accepting new patients
Cheyenne Regional Physicians Group, LLC CurrentSince Jul 13, 2020 Accepting new patients
Sanford Medical Center Fargo CurrentSince Jun 24, 2024 Accepting new patients
Memorial Hospital of Carbon County CurrentSince May 27, 2021 Accepting new patients
Sanford Medical Center Fargo Current Accepting new patients
Regional Employee Assistance Program Inc Cardiovascular Disease CurrentSince Sep 8, 2025 Accepting new patients
Regional Employee Assistance Program Inc CurrentSince Sep 8, 2025 Accepting new patients
Fairview Heights Medical Group SC CurrentSince Oct 1, 2024 Accepting new patients
Sanford Medical Center Fargo CurrentSince Jun 24, 2024 Accepting new patients
Memorial Hospital of Carbon County Current Accepting new patients
Rajiv Agarwal MD PA CurrentSince Feb 6, 2025 Accepting new patients
Memorial Hospital of Carbon County CurrentSince May 27, 2021 Accepting new patients
Fairview Heights Medical Group SC CurrentSince Oct 1, 2024 Accepting new patients
Regional Employee Assistance Program Inc Current Accepting new patients
Cardiovascular Care Providers, Inc. Past Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

6810 State Route 162
Ste 102
Maryville, IL 62062
Phone (618) 288-4076

11155 Dunn Rd
Ste 109N
Saint Louis, MO 63136
Phone (314) 837-3784

1220 Sheyenne St
West Fargo, ND 58078
Phone (701) 234-4445

18835 McKay Dr
Humble, TX 77338
Phone (832) 644-8930

18980 W Memorial Dr
Ste 100
Humble, TX 77338
Phone (832) 644-8930

21703 Kingsland Blvd
Ste 100
Katy, TX 77450
Phone (281) 769-1015

3117 College Park Dr
Ste 200
The Woodlands, TX 77384
Phone (832) 644-8930

2301 House Ave
Ste 301
Cheyenne, WY 82001
Phone (307) 637-1600

4116 Laramie St
Cheyenne, WY 82001
Phone (307) 634-9311

214 E 23rd St
Cheyenne, WY 82001
Phone (307) 324-2221

300 3rd St
Rawlins, WY 82301
Phone (307) 324-3403

2221 Elm St
Rawlins, WY 82301
Phone (307) 324-2221

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CACGBD
  • Direct secure messaging: abdur.khan@hca9.eclinicaldirectplus.com
  • Direct secure messaging: akahn5343904@direct.casso.us.com
  • Direct secure messaging: akhan42437@direct.crmcwy.org

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 6

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": "1343347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1700132750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20970",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820037020",
            "telephone_number": "307-637-1600",
            "fax_number": "307-637-1699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MASSACHUSETTS GENERAL HOSPITAL",
            "address_2": "55 FRUIT STREET",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02114",
            "telephone_number": "617-643-3238"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6810 State Route 162 Ste 102",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "IL",
            "postal_code": "620628560",
            "country_code": "US",
            "telephone_number": "618-288-4076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "ABDUR",
        "middle_name": "RAHMAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-27",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036170870",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WY",
            "license": "12584A",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ND",
            "license": "21278",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MA",
            "license": "278659",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WY",
            "license": "12584A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akhan42437@direct.crmcwy.org",
            "affiliation": "Y",
            "endpointDescription": "CRMC Direct Address",
            "affiliationName": "Memorial Hospital of Laramie County",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "214 E 23rd St",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820013748",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6810 State Route 162 Ste 102",
            "city": "Maryville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620628560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "akhan42437@direct.crmcwy.org",
            "affiliation": "Y",
            "endpointDescription": "CRMC Direct Address",
            "affiliationName": "Memorial Hospital of Laramie County",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "214 E 23rd St",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820013748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.