NPIMap

Individual provider Active NPI

Muhammad Bilal Khan, MD

  • Internal Medicine Physician
  • Tacoma, WA
National Provider Identifier
1770635930
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00042239 Issued in WA
Practice address
1112 S Cushman Ave
Tacoma, WA 98405-3631
Phone
(253) 593-2144
Fax
(253) 593-4125
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00042239 WA Primary

Addresses

Primary practice location

1112 S Cushman Ave
Tacoma, WA 98405-3631

Mailing address

PO Box 26485
Federal Way, WA 98093-3485
Phone (253) 820-6757

Other practice location 1

413 Lilly Rd NE
Olympia, WA 98506-5133
Phone (360) 493-5858

Other identifiers 1

IdentifierTypeStateIssuer
8362014MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mkhan99328@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070828000730 WA Practitioner - Internal MedicinePractitioner - Hospitalist 1759473275 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services WashingtonGroup PAC ID 6709782600, 480 clinicians

Practice addresses (Care Compare)

128 Lilly Rd NE
Suite 205
Olympia, WA 98506-7400
Phone (306) 754-3380

1724 Pointe Woodworth Dr NE
Tacoma, WA 98422-3480
Phone (253) 820-6757

Hospital & facility affiliations

  • Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
  • Providence Centralia Hospital Hospital, Centralia, WA, CCN 500019
  • St Anthony Hospital Hospital, Gig Harbor, WA, CCN 500151

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Oct 1, 2011 Accepting new patients
Providence Health & Services Washington Internal Medicine Current Accepting new patients
Providence Health & Services Washington CurrentSince Dec 15, 2007 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Apr 27, 2017 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Apr 27, 2017 Accepting new patients
Comprehensive Postacute Care PLLC Internal Medicine CurrentSince Jan 1, 2018 Accepting new patients
Lacey SNF Operations LLC Past Accepting new patients
Providence Health & Services Washington Past Accepting new patients

Locations

410 Providence Ln NE
Bldg 2
Olympia, WA 98506
Phone (360) 493-4500

413 Lilly Rd NE
Olympia, WA 98506
Phone (360) 491-9480

700 Lilly Rd NE
Olympia, WA 98506
Phone (360) 923-7000

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: mkhan99328@wm.providencedirect.org

Organizations & group practices 9

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 8

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": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1770635930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26485",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980933485",
            "telephone_number": "253-820-6757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 S CUSHMAN AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984053631",
            "telephone_number": "253-593-2144",
            "fax_number": "253-593-4125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "413 Lilly Rd NE",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985065133",
            "country_code": "US",
            "telephone_number": "360-493-5858",
            "fax_number": "360-486-6436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MUHAMMAD",
        "middle_name": "BILAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00042239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8362014",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkhan99328@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "413 Lilly Rd NE",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985065133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.