Active NPI
Abdur R Khan, MD
- Infectious Disease Physician
- Milwaukee, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- 69966
- Practice address
- 2901 W Kinnickinnic River Pkwy
Milwaukee, WI 53215-3677 - Phone
- (414) 646-8990
- Fax
- (414) 646-8995
- NPI assigned
- Nov 2, 2005
- Last updated
- Oct 20, 2023
- 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 | 35089520 | OH | |
| Internal Medicine Physician | 207R00000X | 21760 | WV | |
| Infectious Disease Physician | 207RI0200X | 69966 | WI | Primary |
Addresses
Primary practice location
2901 W Kinnickinnic River Pkwy
Milwaukee, WI 53215-3677
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Other practice location 1
2200 Philadelphia Dr
Suite 644
Dayton, OH 45406-1840
Phone (937) 278-6874
Other practice location 2
1818 N Meade St Ste 130
Appleton, WI 54911
Phone (920) 831-1841
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100081242 | Medicaid | WI | |
| 3810002265 | Medicaid | WV | |
| 2767840 | Medicaid | OH |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | akhan380875@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH, WI
- 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
- Infectious Disease
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2901 W Kinnickinnic River Pkwy
Milwaukee, WI 53215-3660
Phone (414) 646-8995
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35089520 | OH | MD | Internal Medicine Physician |
| 21760 | WV | MD | Internal Medicine Physician |
| 69966 | WI | MD | Infectious Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeshore Medical Clinic, LLC | Current | Accepting new patients | |
| Premier Health Specialists Inc | Internal Medicine | Current | Accepting new patients |
| Aurora Advanced Healthcare, Inc. | Internal Medicine | Current | Accepting new patients |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Internal Medicine | Current | Accepting new patients |
| Aurora Advanced Healthcare Inc | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Premier Health Specialists Inc | Current | Accepting new patients | |
| Dayton Lung and Sleep Medicine Inc | Past | Accepting new patients |
Locations
30 E Apple St
#6258
Dayton, OH 45409
Phone (937) 208-5300
3170 Kettering Blvd
Bldg B
Moraine, OH 45439
Phone (937) 991-3187
450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773
1818 N Meade St
Ste 130
Appleton, WI 54911
Phone (920) 410-7310
3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100
12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590
2901 W Kinnickinnic River Pkwy
Milwaukee, WI 53215
Phone (414) 385-3084
2901 W Kinnickinnic River Pkwy
Ste 200
Milwaukee, WI 53215
Phone (414) 646-8995
S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747
2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880
Interoperability endpoints
- akhan191886@direct.thedacare.org
- akhan380875@direct.myadvocateaurora.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- St Francis, WI
- NPI 1003861188
-
- Family Medicine Physician
- Milwaukee, WI
- NPI 1265629133
Internal Medicine
-
- Certified Registered Nurse Anesthetist
- Milwaukee, WI
- NPI 1427271378
Internal Medicine
-
- Internal Medicine Physician
- Moraine, OH
- NPI 1194958223
-
- Durable Medical Equipment & Medical Supplies
- Summit, WI
- NPI 1477186633
-
- Durable Medical Equipment & Medical Supplies
- Oshkosh, WI
- NPI 1326858044
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Milwaukee, WI
- NPI 1659599157
-
dba Advanced Ankle and Foot Specialists
- Foot & Ankle Surgery Podiatrist
- Dayton, OH
- NPI 1902211287
-
- Pulmonary Disease Physician
- Englewood, OH
- NPI 1982621751
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Cudahy, WI
- NPI 1235355983
Hospital
-
- General Acute Care Hospital
- Milwaukee, WI
- NPI 1861447179
-
- General Acute Care Hospital
- Grafton, WI
- NPI 1265740195
-
dba Aurora at Home
- Home Health Agency
- West Allis, WI
- NPI 1134255037
-
dba Aurora West Allis Medical Center
- Clinic/Center
- West Allis, WI
- NPI 1235345695
Hospital
-
dba Aurora West Allis Medical Center
- General Acute Care Hospital
- West Allis, WI
- NPI 1407801640
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697760000000",
"number": "1780675439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 735044",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606735044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 W KINNICKINNIC RIVER PKWY",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532153677",
"telephone_number": "414-646-8990",
"fax_number": "414-646-8995"
}
],
"practiceLocations": [
{
"address_1": "2200 Philadelphia Dr",
"address_2": "Suite 644",
"address_purpose": "LOCATION",
"city": "Dayton",
"state": "OH",
"postal_code": "454061840",
"country_code": "US",
"telephone_number": "937-278-6874",
"fax_number": "937-278-7201",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1818 N Meade St Ste 130",
"address_purpose": "LOCATION",
"city": "Appleton",
"state": "WI",
"postal_code": "54911",
"country_code": "US",
"telephone_number": "920-831-1841",
"fax_number": "920-831-1834",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KHAN",
"first_name": "ABDUR",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-02",
"last_updated": "2023-10-20",
"certification_date": "2023-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "35089520",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WV",
"license": "21760",
"primary": false
},
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "WI",
"license": "69966",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100081242",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810002265",
"state": "WV"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2767840",
"state": "OH"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "akhan380875@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2901 W Kinnickinnic River Pkwy",
"city": "Milwaukee",
"state": "WI",
"country_code": "US",
"postal_code": "532153677",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "2901 W Kinnickinnic River Pkwy",
"city": "Milwaukee",
"state": "WI",
"country_code": "US",
"postal_code": "532153677",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; 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.