NPIMap

Individual provider Active NPI

Maryam Khan, MD

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1851824189
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
1019374 Issued in MA
Practice address
840 Harrison Ave
Boston, MA 02118-2905
Phone
(617) 638-6610
Fax
(617) 638-6616
NPI assigned
Apr 4, 2017
Last updated
Apr 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 1019374 MA Primary

Addresses

Primary practice location

840 Harrison Ave
Boston, MA 02118-2905

Mailing address

960 Massachusetts Ave
FL 2
Boston, MA 02118

Other practice location 1

235 N Pearl St
Brockton, MA 02301-1794
Phone (508) 427-2665

Other practice location 2

500 S Preston St Rm 305
Louisville, KY 40202-1702
Phone (502) 852-8696

Other practice location 3

10 Gove St
East Boston, MA 02128
Phone (617) 569-5800

Other practice location 4

736 Cambridge St
Brighton, MA 02135-2907
Phone (617) 789-3000

Other identifiers 2

IdentifierTypeStateIssuer
110211813AMedicaidMA
3151071MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20250822002547 MA Practitioner - Diagnostic Radiology 8628514221 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boston University Medical Center Radiologists, Inc.Group PAC ID 1052392768, 61 clinicians
Internal Medical Associates-EbnhcGroup PAC ID 6103814371, 239 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 638-6610

10 Gove St
East Boston, MA 02128-1920
Phone (617) 569-5800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1019374MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston University Medical Center Radiologists, Inc. Diagnostic Radiology CurrentSince Sep 1, 2025 Accepting new patients
BMC Affiliated Physicians, Inc. Diagnostic Radiology CurrentSince Dec 1, 2025 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients
Internal Medical Associates-Ebnhc CurrentSince Sep 1, 2025 Accepting new patients

Locations

960 Massachusetts Ave
Ste 2
Boston, MA 02118

736 Cambridge St
Brighton, MA 02135
Phone (617) 789-2762

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

10 Grove St
East Boston, MA 02128
Phone (617) 569-5800

1 Boston Medical Ctr Pl
Roxbury, MA 02118
Phone (617) 414-5245

Interoperability endpoints

  • Direct secure messaging: mkhan242319@direct.bmc.masshiway.net

Organizations & group practices 4

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.

Hospital & facility affiliations 8

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": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1851824189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 HARRISON AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182905",
            "telephone_number": "617-638-6610",
            "fax_number": "617-638-6616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "235 N Pearl St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023011794",
            "country_code": "US",
            "telephone_number": "508-427-2665",
            "fax_number": "508-427-2368",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 S Preston St Rm 305",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021702",
            "country_code": "US",
            "telephone_number": "502-852-8696",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10 Gove St",
            "address_purpose": "LOCATION",
            "city": "East Boston",
            "state": "MA",
            "postal_code": "02128",
            "country_code": "US",
            "telephone_number": "617-569-5800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "736 Cambridge St",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "021352907",
            "country_code": "US",
            "telephone_number": "617-789-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MARYAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-04",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "1019374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110211813A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3151071",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.