NPIMap

Individual provider Active NPI

Kashif Z Khan, MD

  • Internal Medicine Physician
  • Amherst, OH
National Provider Identifier
1891768438
Registry record updated Oct 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35086207 Issued in OH
Practice address
578 N Leavitt Rd
Amherst, OH 44001-1131
Phone
(440) 988-5234
Fax
(440) 988-5269
NPI assigned
Feb 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35086207 OH Primary

Addresses

Primary practice location

578 N Leavitt Rd
Amherst, OH 44001-1131

Mailing address

PO Box 636643
Cincinnati, OH 45263-6643
Phone (440) 989-3801

Other identifiers 2

IdentifierTypeStateIssuer
3025372MedicaidOH
2613792MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051104000411 OH Practitioner - Geriatric MedicinePractitioner - Internal Medicine 8022036300 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Lorain Specialty Care LLCGroup PAC ID 4688070055, 134 clinicians

Practice addresses (Care Compare)

578 N Leavitt Rd
Amherst, OH 44001-1131
Phone (440) 960-3912

Hospital & facility affiliations

  • Wellspring Home Health Care Home health agency, Lorain, OH, CCN 369086
  • Wellspring Hospice Hospice, Lorain, OH, CCN 361674
  • Mercy Health-New Life Hospice Hospice, Lorain, OH, CCN 361563
  • Suncrest Hospice Cleveland LLC Hospice, Independence, OH, CCN 361726
  • Mercy Regional Medical Center Hospital, Lorain, OH, CCN 360172
  • Amherst Manor Nursing Home Nursing home, Amherst, OH, CCN 365924
  • Wesleyan Village Nursing home, Elyria, OH, CCN 365162
  • Anchor Lodge Nursing Home Inc Nursing home, Lorain, OH, CCN 365969
  • Autumn Aegis Nursing Home Nursing home, Lorain, OH, CCN 365940
  • Kingston Health Center of Vermilion Nursing home, Vermilion, OH, CCN 365639

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35086207OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Lorain, LLC Internal Medicine CurrentSince May 31, 2015 Accepting new patients
Mercy Health Physicians Lorain Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians, Lorain, LLC CurrentSince May 31, 2015 Accepting new patients
Mercy Health Physicians Lorain Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Anchor Lodge Nursing Home, Inc. Past Accepting new patients
Autumn Aegis, Inc Past Accepting new patients
Lagrange Nursing & Rehabilitation Center, Inc. Past Accepting new patients
Amherst Manor, Inc. Past Accepting new patients
Quantum Healthcare, Inc. Past Accepting new patients
Wesleyan Village LLC Past Accepting new patients
Elms Retirement Village, Inc. Past Accepting new patients
Wessell Generations, Inc. Past Accepting new patients

Locations

578 N Leavitt Rd
Amherst, OH 44001
Phone (440) 960-3912

1957 Cooper Foster Park Rd
Amherst, OH 44001
Phone (440) 989-3801

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

1130 Tower Blvd
Ste B
Lorain, OH 44052
Phone (440) 989-3736

983 Exchange St
Vermilion, OH 44089
Phone (440) 967-6614

Interoperability endpoints

  • Direct secure messaging: kkhan176916@direct.bsmhealth.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Wesleyan Village LLCElyria, OH, CCN 365162 Skilled nursing facility Operational/Managerial Control
Managing Control - Governing Body
Adp of the SNF		 Jul 3, 2019
Jul 3, 2019
Jul 3, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Wesleyan Village LLC
    • Skilled Nursing Facility
    • Elyria, OH
    • NPI 1528065737

    Adp of the SNF, Managing Control - Governing Body, Operational/Managerial Control

    CMS ownership

Organizations & group practices 12

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 11

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539129600000",
    "number": "1891768438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636643",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636643",
            "telephone_number": "440-989-3801",
            "fax_number": "440-960-0264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "578 N LEAVITT RD",
            "city": "AMHERST",
            "state": "OH",
            "postal_code": "440011131",
            "telephone_number": "440-988-5234",
            "fax_number": "440-988-5269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "KASHIF",
        "middle_name": "Z",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2018-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35086207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3025372",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2613792",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, OH

Sources for this page

Verify at the official NPI Registry.