Individual provider Active NPI

Assadulla Khan Khaishgi, M.D.

  • Internal Medicine Physician
  • Northfield, OH
National Provider Identifier
1700981776
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35084523 Issued in OH
Practice address
1756 Sagamore Rd
Northfield, OH 44067-1086
Phone
(330) 467-7131
NPI assigned
Sep 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 35084523 OH Primary

Addresses

Primary practice location

1756 Sagamore Rd
Northfield, OH 44067-1086

Mailing address

30 E Broad St
11 TH FL
Columbus, OH 43215-3414
Phone (614) 466-9930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20040820000309 OH Practitioner - Internal Medicine 4385618909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1756 Sagamore Rd
Northfield, OH 44067-1086
Phone (330) 833-3135

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35084523OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Ohio Office of Budget and Management State Accounting Current Accepting new patients
State of Ohio Office of Budget and Management State Accounting CurrentSince Jul 12, 2004 Accepting new patients
State of Ohio Office of Budget and Management State Accounting CurrentSince Jul 12, 2004 Accepting new patients
State of Ohio Office of Budget and Management State Accounting Past Accepting new patients

Locations

30 E Broad St
Fl 11
Columbus, OH 43215
Phone (614) 466-9930

1756 Sagamore Rd
Northfield, OH 44067
Phone (330) 467-7131

Interoperability endpoints

  • Direct secure messaging: akhaishgi18944@mhas.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700981776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E BROAD ST",
            "address_2": "11 TH FL",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432153414",
            "telephone_number": "614-466-9930",
            "fax_number": "614-644-9116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1756 SAGAMORE RD",
            "city": "NORTHFIELD",
            "state": "OH",
            "postal_code": "440671086",
            "telephone_number": "330-467-7131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAISHGI",
        "first_name": "ASSADULLA",
        "middle_name": "KHAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35084523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northfield, OH

Sources for this page

Verify at the official NPI Registry.