Individual provider Active NPI

Hira Khan, MD

  • Family Medicine Physician
  • Port Huron, MI
National Provider Identifier
1770144164
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301507355 Issued in MI
Practice address
1216 Richardson St
Port Huron, MI 48060-3549
Phone
(810) 985-2640
Fax
(810) 962-8294
NPI assigned
Jun 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301507355 MI Primary

Addresses

Primary practice location

1216 Richardson St
Port Huron, MI 48060-3549

Mailing address

1216 Richardson St
Port Huron, MI 48060-3549
Phone (810) 985-2640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20220805001432 MI Practitioner - Family Practice 3779819164 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Port HuronGroup PAC ID 9931018702, 48 clinicians

Practice addresses (Care Compare)

1216 Richardson St
Port Huron, MI 48060-3549
Phone (810) 987-6218

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301507355MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Port Huron Family Medicine CurrentSince Sep 1, 2022 Accepting new patients
McLaren Port Huron Current Accepting new patients
McLaren Medical Group CurrentSince Aug 1, 2022 Accepting new patients
McLaren Medical Group Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
Blue Water OB & GYN PC PastSince Aug 1, 1999 Accepting new patients

Locations

5979 Lakeshore Rd
Fort Gratiot, MI 48059
Phone (810) 385-6370

1254 N Main St
Lapeer, MI 48446
Phone (810) 664-4531

1750 Busha Hwy
Marysville, MI 48040
Phone (810) 364-4130

1231 Pine Grove Ave
Ste 1B
Port Huron, MI 48060
Phone (810) 984-8650

1313 Stone St
Port Huron, MI 48060
Phone (810) 984-3181

1216 Richardson St
Port Huron, MI 48060
Phone (810) 985-2640

1231 Pine Grove Ave
Port Huron, MI 48060
Phone (313) 610-8707

1163 S Carney Dr
Saint Clair, MI 48079
Phone (810) 561-8450

Organizations & group practices 5

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": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1770144164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 RICHARDSON ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603549",
            "telephone_number": "810-985-2640",
            "fax_number": "810-962-8294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 RICHARDSON ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603549",
            "telephone_number": "810-985-2640",
            "fax_number": "810-962-8294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "HIRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-26",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301507355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.