Active NPI
Ridda Khattak
- Internal Medicine Physician
- Milford, DE
National Provider Identifier
1760233415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- C7-0018500
- Practice address
- 804 N Dupont Blvd
Milford, DE 19963-1006 - Phone
- (302) 725-3200
- NPI assigned
- Apr 1, 2024
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | C7-0018500 | DE | Primary |
Addresses
Primary practice location
804 N Dupont Blvd
Milford, DE 19963-1006
Mailing address
640 S State St
Dover, DE 19901-3530
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240425001805 | DE | Order and Referring Only - Internal Medicine | 2567802473 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C7-0018500 | DE | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711929600000",
"number": "1760233415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "640 S STATE ST",
"city": "DOVER",
"state": "DE",
"postal_code": "199013530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "804 N DUPONT BLVD",
"city": "MILFORD",
"state": "DE",
"postal_code": "199631006",
"telephone_number": "302-725-3200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHATTAK",
"first_name": "RIDDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-01",
"last_updated": "2024-04-01",
"certification_date": "2024-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "DE",
"license": "C7-0018500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milford, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.