Active NPI
Shabbir Khambaty, M.D.
- Pediatrics Physician
- Mankato, MN
National Provider Identifier
1831171545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 35-086105
- Practice address
- 101 Martin Luther King Dr
Mankato, MN 56001-6460 - Phone
- (507) 385-6508
- NPI assigned
- Nov 17, 2005
- Last updated
- Apr 23, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 35-086105 | OH | Primary |
Addresses
Primary practice location
101 Martin Luther King Dr
Mankato, MN 56001-6460
Mailing address
101 Martin Luther King Dr
Mankato, MN 56001-6460
Phone (507) 385-6508
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0-316-723-6 | Other | ECFMG |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35-086105 | OH | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335139200000",
"number": "1831171545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 MARTIN LUTHER KING DR",
"city": "MANKATO",
"state": "MN",
"postal_code": "560016460",
"telephone_number": "507-385-6508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 MARTIN LUTHER KING DR",
"city": "MANKATO",
"state": "MN",
"postal_code": "560016460",
"telephone_number": "507-385-6508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAMBATY",
"first_name": "SHABBIR",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-17",
"last_updated": "2012-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OH",
"license": "35-086105",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ECFMG",
"identifier": "0-316-723-6",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Mankato, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.