Active NPI
Shaheen Khan, MD
- Pediatrics Physician
- Madera, CA
National Provider Identifier
1710081088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- C50433
- Practice address
- 1111 W 4TH St
Madera, CA 93637-4474 - Phone
- (559) 673-3000
- Fax
- (559) 662-2910
- NPI assigned
- Sep 8, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | C50433 | CA | Primary |
Addresses
Primary practice location
1111 W 4TH St
Madera, CA 93637-4474
Mailing address
1111 W 4TH St
Madera, CA 93637-4474
Phone (559) 673-3000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0068140 | Medicaid | CA | |
| LAB13493F | Other | CA | MEDICAID LAB |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C50433 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Madera Family Medical Group Lab | Past | Accepting new patients | |
| Valley Children'S Hospital | Past | Accepting new patients | |
| Saint Agnes Medical Center | Past | Accepting new patients |
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.
-
- Clinical Medical Laboratory
- Madera, CA
- NPI 1538346531
-
- General Acute Care Hospital
- Fresno, CA
- NPI 1205845567
-
- Children's Hospital
- Madera, CA
- NPI 1952312043
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157673600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710081088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 W 4TH ST",
"city": "MADERA",
"state": "CA",
"postal_code": "936374474",
"telephone_number": "559-673-3000",
"fax_number": "559-662-2910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 W 4TH ST",
"city": "MADERA",
"state": "CA",
"postal_code": "936374474",
"telephone_number": "559-673-3000",
"fax_number": "559-662-2910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "SHAHEEN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "C50433",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0068140",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID LAB",
"identifier": "LAB13493F",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Madera, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.