Individual provider Active NPI

Mohammad Khan, M.D.

  • Internal Medicine Physician
  • Hartford, CT
National Provider Identifier
1780069930
Registry record updated Aug 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
71936 Issued in CT
Practice address
80 Seymour St BLDG 502
Hartford, CT 06102-8000
Phone
(860) 972-0549
Fax
(860) 545-5221
NPI assigned
Jul 29, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD16238 RI
Internal Medicine Physician 207R00000X LP03487 RI
Internal Medicine Physician 207R00000X 71936 CT Primary

Addresses

Primary practice location

80 Seymour St BLDG 502
Hartford, CT 06102-8000

Mailing address

111 Brewster St
Pawtucket, RI 02860-4474
Phone (401) 729-2258

Other practice location 1

111 Brewster St
Pawtucket, RI 02860
Phone (401) 729-2258

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180711000449 RI Practitioner - Internal Medicine 0648586537 Reassigns benefits to 1 organization
I20200416002671 CT Practitioner - Internal Medicine 0648586537 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Associates LLCGroup PAC ID 9234156985, 208 clinicians
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

25 Wells St
Westerly, RI 02891-2922
Phone (401) 348-3325

80 Seymour St
Hartford, CT 06102-8000
Phone (860) 972-0549

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

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 Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Sep 1, 2024 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Sep 1, 2024 Accepting new patients
Hospital Medicine Associates LLC Internal Medicine CurrentSince Jul 1, 2018 Accepting new patients

Locations

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

5870 N Hiatus Rd
Tamarac, FL 33321
Phone (957) 377-2954

25 Wells St
Westerly, RI 02891
Phone (401) 348-3325

Interoperability endpoints

  • Direct secure messaging: mohammadmudassarahmed.khan@xdr.hhchealthdirect.org
  • Direct secure messaging: mkhan399636@direct.ynhh.org

Organizations & group practices 3

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 3

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": "1438128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1780069930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BREWSTER ST",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028604474",
            "telephone_number": "401-729-2258",
            "fax_number": "401-729-3343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEYMOUR ST BLDG 502",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061028000",
            "telephone_number": "860-972-0549",
            "fax_number": "860-545-5221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Brewster St",
            "address_purpose": "LOCATION",
            "city": "Pawtucket",
            "state": "RI",
            "postal_code": "02860",
            "country_code": "US",
            "telephone_number": "401-729-2258",
            "fax_number": "401-729-3343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MOHAMMAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-29",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD16238",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "LP03487",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "71936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.