Organization Active NPI

Mahmood a Khan Primary Care PC

  • Adult Medicine Physician
  • Amsterdam, NY
National Provider Identifier
1831409614
Registry record updated Oct 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
MAHMOOD A KHAN PRIMARY CARE PC
Practice address
5032 State Highway 30
Medical Plaza
Amsterdam, NY 12010-7534
Phone
(518) 842-0200
Fax
(518) 842-3003
NPI assigned
Oct 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2010

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

Authorized official

Name
Dr. Mahmood Ahmad Khan, M.D.NPI 1265480073
Title
Physician
Phone
(518) 842-0200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0505X Primary

Addresses

Primary practice location

5032 State Highway 30
Medical Plaza
Amsterdam, NY 12010-7534

Mailing address

5032 State Highway 30
Medical Plaza
Amsterdam, NY 12010-7534
Phone (518) 842-0200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110301000720 NY Part B Supplier - Clinic/Group Practice 3870774573 Receives reassigned benefits from 1 practitioner
Practice locations: Amsterdam, NY

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
33D1030364Mahmood a Khan Primary Care PC5032 State Highway 30, Amsterdam, NY 12010Certificate of waiverFeb 5, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1287014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287014400000",
    "number": "1831409614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5032 STATE HIGHWAY 30",
            "address_2": "MEDICAL PLAZA",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120107534",
            "telephone_number": "518-842-0200",
            "fax_number": "518-842-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5032 STATE HIGHWAY 30",
            "address_2": "MEDICAL PLAZA",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120107534",
            "telephone_number": "518-842-0200",
            "fax_number": "518-842-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHMOOD A KHAN PRIMARY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-14",
        "last_updated": "2010-10-14",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "MAHMOOD",
        "authorized_official_middle_name": "AHMAD",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "518-842-0200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amsterdam, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; 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.