NPIMap

Individual provider Active NPI

Justin Khine, MD

  • Nephrology Physician
  • Longmont, CO
National Provider Identifier
1851956486
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
DR.0073316 Issued in CO
Practice address
1960 Ken Pratt Blvd
Longmont, CO 80501-6045
Phone
(248) 330-5135
NPI assigned
May 9, 2019
Last updated
Aug 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X DR.0073316 CO Primary

Addresses

Primary practice location

1960 Ken Pratt Blvd
Longmont, CO 80501-6045

Mailing address

1960 Ken Pratt Blvd
Longmont, CO 80501-6045
Phone (248) 330-5135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, CO2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240229000345 TN Practitioner - Internal Medicine 8921334707 Reassigns benefits to 1 organization
I20240606003321 CO Practitioner - Nephrology 8921334707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Nephrology and Metabolic Bone Disease, P.C.Group PAC ID 2264428622, 33 clinicians

Practice addresses (Care Compare)

1960 Ken Pratt Blvd
Suite B
Longmont, CO 80501-6092
Phone (303) 776-7759

5265 Vance St
Suite 200
Arvada, CO 80002-3714
Phone (303) 232-3366

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.99 of 100Reported as group
Quality
89.64
Promoting interoperability
98
Improvement activities
40
Cost
74.36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0073316COMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Physician Services PC CurrentSince Jan 24, 2024 Accepting new patients
Western Nephrology & Metabolic Bone Disease, P.C. Nephrology CurrentSince May 4, 2024 Accepting new patients
Western Nephrology & Metabolic Bone Disease, P.C. Nephrology PastSince Sep 20, 2020 Accepting new patients
Western Nephrology & Metabolic Bone Disease, P.C. Nephrology PastSince Sep 13, 2020 Accepting new patients
Tapestry Telehealth PLLC Past Accepting new patients

Locations

5265 Vance St
Ste 200
Arvada, CO 80002
Phone (303) 232-3366

1960 Ken Pratt Blvd
Ste B
Longmont, CO 80501
Phone (303) 443-4200

4891 Independence St
Ste 120
Wheat Ridge, CO 80033
Phone (303) 232-3366

6019 Walnut Grove Rd
Memphis, TN 38120
Phone (901) 226-3190

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ACHACA

Organizations & group practices 5

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 40

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1851956486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 KEN PRATT BLVD",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016045",
            "telephone_number": "248-330-5135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 KEN PRATT BLVD",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805016045",
            "telephone_number": "248-330-5135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHINE",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-09",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CO",
            "license": "DR.0073316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longmont, CO

Sources for this page

Verify at the official NPI Registry.