Individual provider Active NPI

Ashraf I Khan, DO

  • Pain Medicine Physician
  • Clarkston, MI
National Provider Identifier
1881702892
Registry record updated Aug 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
AK011353 Issued in MI
Practice address
5625 Water Tower PL
Suite 220
Clarkston, MI 48346-2671
Phone
(248) 620-4265
Fax
(248) 620-4262
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X AK011353 MI Primary

Addresses

Primary practice location

5625 Water Tower PL
Suite 220
Clarkston, MI 48346-2671

Mailing address

1701 Lake Lansing Rd
Suite 100
Lansing, MI 48912-3798
Phone (517) 485-0001

Other identifiers 2

IdentifierTypeStateIssuer
3326123MedicaidMI
0556302985OtherMIBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040506000175 MI Practitioner - Interventional Pain ManagementPractitioner - Anesthesiology 2163410192 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Anesthesiology
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
McLaren OaklandGroup PAC ID 0547173213, 51 clinicians

Practice addresses (Care Compare)

50 N Perry St
Pontiac, MI 48342-2217
Phone (248) 338-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AK011353MIMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Oakland CurrentSince Nov 3, 2018 Accepting new patients
McLaren Oakland CurrentSince Nov 3, 2018 Accepting new patients
Pontiac Anesthesia Care Associates, PLLC Past Accepting new patients

Locations

8172 Reliable Pkwy
Chicago, IL 60686
Phone (517) 908-0847

5625 Water Tower Pl
Ste 220
Clarkston, MI 48346
Phone (248) 620-4265

5625 Water Tower Pl
Clarkston, MI 48346
Phone (248) 620-4245

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

Organizations & group practices 3

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 1

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186358400000",
    "number": "1881702892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 LAKE LANSING RD",
            "address_2": "SUITE 100",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489123798",
            "telephone_number": "517-485-0001",
            "fax_number": "517-485-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5625 WATER TOWER PL",
            "address_2": "SUITE 220",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462671",
            "telephone_number": "248-620-4265",
            "fax_number": "248-620-4262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "ASHRAF",
        "middle_name": "I",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "MI",
            "license": "AK011353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3326123",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0556302985",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, MI

Sources for this page

Verify at the official NPI Registry.