Individual provider Active NPI

Moeez A Khan

  • Emergency Medicine Physician
  • Stratford, NJ
National Provider Identifier
1770012049
Registry record updated Aug 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OS16623 Issued in FL
Practice address
18 E Laurel Rd
Stratford, NJ 08084-1327
Phone
(856) 346-7985
NPI assigned
Jun 8, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OS16623 FL Primary

Addresses

Primary practice location

18 E Laurel Rd
Stratford, NJ 08084-1327

Mailing address

1431 Centerpoint Blvd Ste 100
Knoxville, TN 37932-1983

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200914001452 FL Practitioner - Emergency Medicine 3779901335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Lake Erie College of Osteopathic Medicine, Bradenton, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Emergency Physicians Kang and Associates MD LLCGroup PAC ID 0143113878, 318 clinicians

Practice addresses (Care Compare)

601 E Altamonte Dr
Emergency Department
Altamonte Springs, FL 32701-4802
Phone (407) 303-2200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS16623FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Emergency Physicians Kang and Associates MD LLC Emergency Medicine CurrentSince Aug 1, 2020 Accepting new patients

Locations

601 E Altamonte Dr
Altamonte Springs, FL 32701
Phone (407) 303-2200

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

Organizations & group practices 1

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 2

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": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598486400000",
    "number": "1770012049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 CENTERPOINT BLVD STE 100",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379321983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 E LAUREL RD",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841327",
            "telephone_number": "856-346-7985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MOEEZ",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-08",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "OS16623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, NJ

Sources for this page

Verify at the official NPI Registry.