Individual provider Active NPI

Ali R Khan, MD

  • Family Medicine Physician
  • Marana, AZ
National Provider Identifier
1760714380
Registry record updated Jul 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
45692 Issued in AZ
Practice address
13395 N Marana Main St
Marana, AZ 85653-7008
Phone
(520) 682-4111
Fax
(520) 682-3817
NPI assigned
Feb 6, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 003975 GA
Family Medicine Physician 207Q00000X 45692 AZ Primary

Addresses

Primary practice location

13395 N Marana Main St
Marana, AZ 85653-7008

Mailing address

PO Box 188
Marana, AZ 85653-0188
Phone (520) 682-4111

Other identifiers 1

IdentifierTypeStateIssuer
716399MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20170828000209 TX Practitioner - Family Practice 2769632306 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MMH PhysiciansGroup PAC ID 1759675911, 29 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

400 Rosalind Redfern Grover Pkwy
Midland, TX 79701-5846
Phone (432) 221-1111

4001 W 15TH St
245 Usmd Plano W
Plano, TX 75093-5839
Phone (972) 596-5222

800 College Pkwy
Lewisville, TX 75077-3503
Phone (972) 420-8543

900 Airport Fwy
Suite 158
Hurst, TX 76054-3253
Phone (817) 514-4000

9255 Dallas Pkwy
Suite 110
Frisco, TX 75033-4211
Phone (972) 377-1490

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45692AZMDFamily Medicine Physician
003975GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Clinic of North Texas, PLLC Family Medicine CurrentSince Dec 21, 2024 Accepting new patients
Medical Clinic of North Texas PLLC CurrentSince Dec 21, 2024 Accepting new patients
MMH Physicians CurrentSince Jul 9, 2017 Accepting new patients
Medical Clinic of North Texas, PLLC Family Medicine Current Accepting new patients
Lonestar Hospital Medicine Associates, PA CurrentSince Aug 1, 2018 Accepting new patients
Marana Health Center, Inc Past Accepting new patients

Locations

2601 W Randol Mill Rd
Arlington, TX 76012
Phone (817) 274-5571

901 W Ben White Blvd
Austin, TX 78704
Phone (512) 342-2382

2000 Scenic Dr
Georgetown, TX 78626
Phone (512) 863-2117

900 Airport Fwy
Ste 158
Hurst, TX 76054
Phone (817) 514-4000

8080 State Highway 121
Ste 300
McKinney, TX 75070
Phone (972) 268-9383

400 Rosalind Redfern Grover Pkwy
Midland, TX 79701
Phone (432) 221-4850

4001 W 15th St
Ste 245
Plano, TX 75093
Phone (972) 596-5222

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

Interoperability endpoints

  • Direct secure messaging: ali.khan.p52@direct.tenet.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: ali.khan@wellmed.eclinicaldirectplus.com

Organizations & group practices 7

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 7

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": "1265414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437350400000",
    "number": "1760714380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856530188",
            "telephone_number": "520-682-4111",
            "fax_number": "520-818-3630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13395 N MARANA MAIN ST",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856537008",
            "telephone_number": "520-682-4111",
            "fax_number": "520-682-3817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "ALI",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-06",
        "last_updated": "2015-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "003975",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "45692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "716399",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marana, AZ

Sources for this page

Verify at the official NPI Registry.