NPIMap

Individual provider Active NPI

Mukul Khandelwal, MD

  • Gastroenterology Physician
  • Pasadena, MD
National Provider Identifier
1871595942
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
D0052387 Issued in MD
Practice address
8109 Ritchie Hwy
Pasadena, MD 21122-6917
Phone
(410) 590-8920
Fax
(410) 553-2345
NPI assigned
Aug 10, 2005
Last updated
Aug 30, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X D0052387 MD Primary

Addresses

Primary practice location

8109 Ritchie Hwy
Pasadena, MD 21122-6917

Mailing address

502 Pinefield Dr
Severna Park, MD 21146-2320
Phone (410) 590-8920

Other identifiers 1

IdentifierTypeStateIssuer
369600600MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, OK2 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
I20040721001238 MD Practitioner - Gastroenterology 0042299257 Reassigns benefits to 1 organization
I20260409001893 OK Practitioner - Gastroenterology 0042299257 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Icahn School of Medicine at Mount Sinai, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integris Ambulatory Care CorporationGroup PAC ID 2365408465, 687 clinicians
Mukul Khandelwal, PAGroup PAC ID 7416936620, 14 clinicians

Practice addresses (Care Compare)

4401 S Western Ave
Oklahoma City, OK 73109-3413
Phone (405) 636-7000

85 Kindred Way
Apt 201
Glen Burnie, MD 21061-5249
Phone (410) 590-8920

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.34 of 100Reported as group
Quality
25
Promoting interoperability
98
Improvement activities
40
Cost
87.79

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy441
Upper gastrointestinal (GI) endoscopy for acid reflux84

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0052387MDMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mukul Khandelwal, PA Gastroenterology CurrentSince Jan 20, 2004 Accepting new patients
Central Maryland Endoscopy LLC Gastroenterology CurrentSince Aug 17, 2005 Accepting new patients
Central Maryland Anesthesia, LLC CurrentSince Aug 22, 2014 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

8186 Lark Brown Rd
Ste 104
Elkridge, MD 21075
Phone (410) 590-8920

85 Kindred Way
Apt 201
Glen Burnie, MD 21061
Phone (410) 355-2244

8028 Ritchie Hwy
Ste 142
Pasadena, MD 21122
Phone (410) 590-8920

8109 Ritchie Hwy
Pasadena, MD 21122
Phone (410) 590-8750

Interoperability endpoints

  • Direct secure messaging: mkhandelwal@772.securemail.prognocis.com

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 4

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1871595942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 PINEFIELD DR",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211462320",
            "telephone_number": "410-590-8920",
            "fax_number": "410-553-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8109 RITCHIE HWY",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211226917",
            "telephone_number": "410-590-8920",
            "fax_number": "410-553-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANDELWAL",
        "first_name": "MUKUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MD",
            "license": "D0052387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "369600600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, MD

Sources for this page

Verify at the official NPI Registry.