Organization Active NPI

Mohamed Wajeed Khan, M.D. L.L.C.

  • Internal Medicine Physician
  • Wheaton, MD
National Provider Identifier
1811226012
Registry record updated Dec 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0032817 Issued in MD
Legal business name
MOHAMED WAJEED KHAN, M.D. L.L.C.
Practice address
12016 Georgia Ave
Wheaton, MD 20902-2004
Phone
(301) 942-2105
NPI assigned
Dec 17, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2009

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

Authorized official

Name
Mohamed Wajeed Khan, M.D.
Title
Physician
Phone
(301) 942-2105

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X D0032817 MD Primary

Addresses

Primary practice location

12016 Georgia Ave
Wheaton, MD 20902-2004

Mailing address

12016 Georgia Ave
Wheaton, MD 20902-2004

Other identifiers 1

IdentifierTypeStateIssuer
356121600MedicaidMD

Other names 1

  • M. Wajeed Khan, M.D, Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091231000097 DC Part B Supplier - Clinic/Group Practice 3971644725 Receives reassigned benefits from 1 practitioner
Practice locations: Wheaton, MD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D0720582M Wajeed Khan PHD MD12016 Georgia Avenue, Silver Spring, MD 20902Certificate of waiverOct 27, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1261008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261008000000",
    "number": "1811226012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12016 GEORGIA AVE",
            "city": "WHEATON",
            "state": "MD",
            "postal_code": "209022004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12016 GEORGIA AVE",
            "city": "WHEATON",
            "state": "MD",
            "postal_code": "209022004",
            "telephone_number": "301-942-2105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHAMED WAJEED KHAN, M.D. L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-17",
        "last_updated": "2009-12-17",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_middle_name": "WAJEED",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "301-942-2105",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0032817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "356121600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "M. Wajeed Khan, M.D,",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wheaton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.