Active NPI
Mohammad Khan, M.D.
- Internal Medicine Physician
- Hartford, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 71936
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
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
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 100
- Quality
- 83.36
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.9
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hartford Healthcare Medical Group Specialists, PLLC | Current | Accepting new patients | |
| Hartford Healthcare Medical Group Specialists LLC | Current | Accepting new patients | |
| Hospital Medicine Associates LLC | Internal Medicine | Current | 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
- mohammadmudassarahmed.khan@xdr.hhchealthdirect.org
- 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.
-
- Surgery Physician
- Hartford, CT
- NPI 1023584216
-
- Hospitalist Physician
- Baton Rouge, LA
- NPI 1093758781
CT, Internal Medicine, RI
-
- Customized Equipment (DME)
- Groton, CT
- NPI 1295367068
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Hartford, CT
- NPI 1770696643
-
- General Acute Care Hospital
- Hartford, CT
- NPI 1902834880
-
- General Acute Care Hospital
- Westerly, RI
- NPI 1447595368
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.