Individual provider Active NPI

Rizwan Ahmad Khan, M.D.

  • Interventional Cardiology Physician
  • Carbondale, IL
National Provider Identifier
1902288855
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
036160254 Issued in IL
Practice address
409 W Oak St
Carbondale, IL 62901-1464
Phone
(618) 529-4455
Fax
(618) 351-1287
NPI assigned
Jun 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 31631 OK
Cardiovascular Disease Physician 207RC0000X 036160254 IL
Interventional Cardiology Physician 207RI0011X 036160254 IL Primary

Addresses

Primary practice location

409 W Oak St
Carbondale, IL 62901-1464

Mailing address

PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 457-5200

Other practice location 1

217 S Park Ave Ste 2
Herrin, IL 62948-3611
Phone (618) 529-4455

Other practice location 2

900 N Washington St Ste 2
Du Quoin, IL 62832-1233
Phone (618) 529-4455

Other practice location 3

3905 W Ernestine Dr
Marion, IL 62959-5800
Phone (618) 529-4455

Other practice location 4

100 Dr Warren Tuttle Dr
Harrisburg, IL 62946-2718
Phone (618) 253-7671

Electronic endpoints 5

TypeEndpointUseAffiliation
Direct Messaging Address rkhan61762@sih.direct-ci.com
Direct Messaging Address rkhan61762@sih.direct-ci.com
Direct Messaging Address rkhan61762@sih.direct-ci.com
Direct Messaging Address rkhan61762@sih.direct-ci.com
Direct Messaging Address rkhan61762@sih.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20220726002626 IL Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 6800149949 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harrisburg Medical Center IncGroup PAC ID 9638083884, 19 clinicians

Practice addresses (Care Compare)

100 Dr Warren Tuttle Dr
Harrisburg, IL 62946-2718
Phone (618) 253-7671

409 W Oak St
Carbondale, IL 62901-1414
Phone (618) 529-4455

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
55.9
Promoting interoperability
100
Improvement activities
40
Cost
72.01

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting16
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31631OKMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franklin Hospital District Current Accepting new patients
Franklin Hospital District Internal Medicine CurrentSince Jul 25, 2022 Accepting new patients
Franklin Hospital District CurrentSince Jul 25, 2022 Accepting new patients
Harrisburg Medical Center Inc CurrentSince Dec 1, 2024 Accepting new patients
Southern Illinois Medical Services, NFP Internal Medicine CurrentSince Jul 25, 2022 Accepting new patients
Harrisburg Medical Center Inc Past Accepting new patients

Locations

201 Bailey Ln
Benton, IL 62812
Phone (618) 438-3113

409 W Oak St
Carbondale, IL 62901
Phone (618) 536-2565

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

1239 E Main St
Carbondale, IL 62901

900 N Washington St
Ste 2
Du Quoin, IL 62832

900 N Washington St
Du Quoin, IL 62832
Phone (618) 542-1050

100 Dr Warren Tuttle Dr
Harrisburg, IL 62946
Phone (618) 252-4956

217 S Park Ave
Ste 2
Herrin, IL 62948

3106 Outer Dr
Marion, IL 62959
Phone (618) 997-4332

3905 W Ernestine Dr
Marion, IL 62959
Phone (573) 331-5761

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/harrisb-43985171

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.

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": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1902288855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "618-457-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W OAK ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011464",
            "telephone_number": "618-529-4455",
            "fax_number": "618-351-1287"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "217 S Park Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483611",
            "country_code": "US",
            "telephone_number": "618-529-4455",
            "fax_number": "618-351-1287",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 N Washington St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Du Quoin",
            "state": "IL",
            "postal_code": "628321233",
            "country_code": "US",
            "telephone_number": "618-529-4455",
            "fax_number": "618-351-1287",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3905 W Ernestine Dr",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "IL",
            "postal_code": "629595800",
            "country_code": "US",
            "telephone_number": "618-529-4455",
            "fax_number": "618-351-1287",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Dr Warren Tuttle Dr",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "IL",
            "postal_code": "629462718",
            "country_code": "US",
            "telephone_number": "618-253-7671",
            "fax_number": "618-252-7274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "RIZWAN",
        "middle_name": "AHMAD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-26",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "31631",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036160254",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "IL",
            "license": "036160254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkhan61762@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "409 W Oak St",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011464",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkhan61762@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "3905 W Ernestine Dr",
            "city": "Marion",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629595800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkhan61762@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "217 S Park Ave Ste 2",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629483611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkhan61762@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "900 N Washington St Ste 2",
            "city": "Du Quoin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628321233",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rkhan61762@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "100 Dr Warren Tuttle Dr",
            "city": "Harrisburg",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629462718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.