Individual provider Active NPI

Adeel N Khan, M.D.

  • Ophthalmology Physician
  • Fort Wayne, IN
National Provider Identifier
1841510294
Registry record updated Sep 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
0037512 Issued in TX
Practice address
11188 Diebold Rd
Fort Wayne, IN 46845-9662
Phone
(260) 483-9500
Fax
(260) 483-9511
NPI assigned
Jun 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 0037512 TX Primary

Addresses

Primary practice location

11188 Diebold Rd
Fort Wayne, IN 46845-9662

Mailing address

1481 West 10TH Street
Indianapolis, IN 46202-2803
Phone (713) 922-5538

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131016001268 IN Practitioner - Ophthalmology 8325272883 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Texas a & M University System, HSC, College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7621 W Jefferson Blvd
Fort Wayne, IN 46804-4133
Phone (260) 436-2181

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0037512TXMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allen County Retinal Surgeons, P.C. Ophthalmology CurrentSince Apr 29, 2019 Accepting new patients

Locations

7900 W Jefferson Blvd
Ste 300
Fort Wayne, IN 46804
Phone (219) 436-2181

7621 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (219) 436-2181

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506297600000",
    "number": "1841510294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1481 WEST 10TH STREET",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022803",
            "telephone_number": "713-922-5538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11188 DIEBOLD RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468459662",
            "telephone_number": "260-483-9500",
            "fax_number": "260-483-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "ADEEL",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-08",
        "last_updated": "2017-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "0037512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.