Individual provider Active NPI

Angabeen S Khan, MD

  • Diagnostic Radiology Physician
  • New London, CT
National Provider Identifier
1871575381
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
039503 Issued in CT
Practice address
365 Montauk Ave
New London, CT 06320
Phone
(860) 444-5151
NPI assigned
Nov 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 246430 MA
Diagnostic Radiology Physician 2085R0202X 039503 CT Primary

Addresses

Primary practice location

365 Montauk Ave
New London, CT 06320

Mailing address

PO Box 547
Windsor, CT 06095-0547
Phone (860) 925-6482

Other practice location 1

85 Seymour St
Suite 400
Hartford, CT 06106-5501
Phone (860) 289-3375

Other practice location 2

85 Seymour St
Suite 400
Hartford, CT 06106-5501
Phone (860) 289-3375

Other identifiers 1

IdentifierTypeStateIssuer
1395038MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, RI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040318001080 CT Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 8123916152 Reassigns benefits to 4 organizations
I20190716003248 RI Practitioner - Diagnostic Radiology 8123916152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ocean Radiology Associates PCGroup PAC ID 1951315779, 26 clinicians

Practice addresses (Care Compare)

25 Wells St
Westerly, RI 02891-2922
Phone (860) 442-0711

365 Montauk Ave
New London, CT 06320-4700
Phone (860) 442-0711

Hospital & facility affiliations

  • Lawrence & Memorial Hospital Hospital, New London, CT, CCN 070007
  • Westerly Hospital Hospital, Westerly, RI, CCN 410013
  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022

Merit-based Incentive Payment System (MIPS)

Final score
66.86 of 100Reported as individual
Quality
54.61
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
039503CTMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tic, LLC Diagnostic Radiology CurrentSince Sep 1, 2016 Accepting new patients
Ocean Radiology Associates PC Diagnostic Radiology CurrentSince Mar 1, 2019 Accepting new patients
Prohealth Physicians PC Past Accepting new patients

Locations

399 Farmington Ave
Lowr 1
Farmington, CT 06032

85 Seymour St
Ste 200
Hartford, CT 06106
Phone (860) 246-6589

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

6 Fieldstone Cmns
Ste E
Tolland, CT 06084
Phone (860) 896-4847

25 Wells St
Westerly, RI 02891
Phone (401) 348-3325

Interoperability endpoints

  • Direct secure messaging: akhan428955@direct.ynhh.org
  • Direct secure messaging: angabeen.khan@xdr.hhchealthdirect.org

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1871575381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060950547",
            "telephone_number": "860-925-6482",
            "fax_number": "860-611-4319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "06320",
            "telephone_number": "860-444-5151"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "85 Seymour St",
            "address_2": "Suite 400",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061065501",
            "country_code": "US",
            "telephone_number": "860-289-3375",
            "fax_number": "860-783-5733",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "85 Seymour St",
            "address_2": "Suite 400",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061065501",
            "country_code": "US",
            "telephone_number": "860-289-3375",
            "fax_number": "860-783-5733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "ANGABEEN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "246430",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CT",
            "license": "039503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1395038",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

Verify at the official NPI Registry.