Individual provider Active NPI

Zia Ullah Khan, M.D

  • Addiction Medicine (Family Medicine) Physician
  • Cleveland, OH
National Provider Identifier
1871752519
Registry record updated Mar 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
35.133441 Issued in OH
Practice address
5209 Euclid Ave
Cleveland, OH 44103-3703
Phone
(216) 881-0765
Fax
(216) 431-2190
NPI assigned
Jun 6, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X 35.133441 OH Primary

Addresses

Primary practice location

5209 Euclid Ave
Cleveland, OH 44103-3703

Mailing address

5209 Euclid Ave
Cleveland, OH 44103-3703
Phone (216) 881-0765

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, NY2 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
I20190521001812 OH Practitioner - Addiction MedicinePractitioner - Family Practice 7315280013
I20240829000273 NY Practitioner - Psychiatry 7315280013 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.133441OHMDAddiction Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St.Vincent' Hospital Westchester Psych CurrentSince Jun 30, 2024 Accepting new patients
Community Counseling Center of Ashtabula County CurrentSince Jul 6, 2019 Accepting new patients
St Josephs Hospital Yonkers CurrentSince Jun 30, 2024 Accepting new patients
St. Joseph'S Hospital Yonkers Anatomic Pathology & Clinical Pathology Current Accepting new patients
St. Joseph'S Hospital, Yonkers CurrentSince Jul 9, 2021 Accepting new patients
Fortaleza,LLC Addiction Medicine PastSince May 1, 2019 Accepting new patients

Locations

275 North St
Harrison, NY 10528
Phone (914) 925-5211

2801 C Ct
Ashtabula, OH 44004
Phone (440) 998-0722

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584403200000",
    "number": "1871752519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5209 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441033703",
            "telephone_number": "216-881-0765",
            "fax_number": "216-431-2190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5209 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441033703",
            "telephone_number": "216-881-0765",
            "fax_number": "216-431-2190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "ZIA",
        "middle_name": "ULLAH",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-06",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "OH",
            "license": "35.133441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.