NPIMap

Individual provider Active NPI

Mohamedaouf Khaznadar, MD

  • Internal Medicine Physician
  • Amarillo, TX
National Provider Identifier
1790712784
Registry record updated Feb 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
K1504 Issued in TX
Practice address
1901 Medi Park Dr
Suite 124
Amarillo, TX 79106-2110
Phone
(806) 359-9866
Fax
(806) 359-1180
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2010

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 K1504 TX Primary

Addresses

Primary practice location

1901 Medi Park Dr
Suite 124
Amarillo, TX 79106-2110

Mailing address

1901 Medi Park Dr
Suite 124
Amarillo, TX 79106-2110
Phone (806) 359-9866

Other identifiers 8

IdentifierTypeStateIssuer
110190468OtherRAILROAD MEDICARE
135305411MedicaidTX
135305413MedicaidTX
135306406MedicaidTX
0045DVOtherBLUE CROSS
135305412MedicaidTX
752836096OtherTAX ID #
116723101OtherFIRSTCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20090114000405 TX Practitioner - Internal Medicine 0749343929 Reassigns benefits to 1 organization
Receives reassigned benefits from 1 practitioner
Practice locations: Amarillo, TX

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1200 Wallace Blvd
Amarillo, TX 79106-1741
Phone (806) 351-4152

1901 Medi Park Dr
Suite 124
Amarillo, TX 79106-2106
Phone (806) 359-9866

Hospital & facility affiliations

  • Bsa Compassion Home Care Home health agency, Amarillo, TX, CCN 677943
  • Centerwell Home Health Home health agency, Amarillo, TX, CCN 457590
  • Enhabit Home Health Home health agency, Amarillo, TX, CCN 677447
  • Accentcare Health Home health agency, Amarillo, TX, CCN 457754
  • High Plains Senior Care, LLC Home health agency, Amarillo, TX, CCN 459482
  • Northwest Texas Hospital Hospital, Amarillo, TX, CCN 450209
  • Bsa Hospital Hospital, Amarillo, TX, CCN 450231
  • Quail Creek Surgical Hospital Hospital, Amarillo, TX, CCN 450875
  • Texas Specialty Hospital Inpatient rehabilitation facility, Amarillo, TX, CCN 45TA60
  • Rehabilitation Hospital of Amarillo Inpatient rehabilitation facility, Amarillo, TX, CCN 743035
  • Amarillo Rehabilitation Hospital Inpatient rehabilitation facility, Amarillo, TX, CCN 453096
  • Texas Specialty Hospital Long-term care hospital, Amarillo, TX, CCN 452060

Merit-based Incentive Payment System (MIPS)

Final score
18.75 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
62.51

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue2251
Removal of skin lesions12
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K1504TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healogics Specialty Physicians of Texas, PLLC Internal Medicine CurrentSince Dec 1, 2021 Accepting new patients
Physicians and Allied Health Professionals Group, PA Internal Medicine Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Locations

1105 Central Expy N
Ste 2210
Allen, TX 75013
Phone (972) 747-4325

1200 Wallace Blvd
Amarillo, TX 79106
Phone (806) 351-4150

Interoperability endpoints

  • Direct secure messaging: mkhaznadar87620@ahs.direct-ci.com

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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 11

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265846400000",
    "number": "1790712784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 MEDI PARK DR",
            "address_2": "SUITE 124",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791062110",
            "telephone_number": "806-359-9866",
            "fax_number": "806-359-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 MEDI PARK DR",
            "address_2": "SUITE 124",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791062110",
            "telephone_number": "806-359-9866",
            "fax_number": "806-359-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAZNADAR",
        "first_name": "MOHAMEDAOUF",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2010-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K1504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110190468",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135305411",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135305413",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135306406",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0045DV",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135305412",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "752836096",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE",
            "identifier": "116723101",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.