Mamoona Hameed Khan

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1075815 Issued in TX

Practice address

43825 Michigan Ave
Canton, MI 48188-2551

Phone

(734) 397-3088

NPI assigned

Sep 14, 2020

Last updated

Aug 1, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Huntsville Memorial Hospital Hospital, Huntsville, TX, CCN 450347

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Rising Mind Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Houston, TX
  • NPI 1639034945
  Medicare reassignment NPD Authorized official
• Gateway Psych Care PLLC

  • Psychiatry Physician
  • Katy, TX
  • NPI 1386499457
  Medicare reassignment
• Heartland Physicians Associates Nephrology PLLC

  • Nephrology Physician
  • Shenandoah, TX
  • NPI 1659916617
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Huntsville Community Hospital, Inc.

  dba Huntsville Memorial Hospital

  • General Acute Care Hospital
  • Huntsville, TX
  • NPI 1245878990
  Care Compare affiliation

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1902411259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43825 MICHIGAN AVE",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43825 MICHIGAN AVE",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882551",
            "telephone_number": "734-397-3088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MAMOONA",
        "middle_name": "HAMEED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704365990",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1075815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000000",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mamoonazafar1@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "43825 Michigan Ave",
            "city": "Canton",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481882551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bader Fatima Khan, MD
• Farah N Khan, DDS
• Hana Khan
• Hanif Ahmed Khan, MD
• Huma Khan, MD
• Nafiah Khan
• Rida Khan
• Safiyyah Fatima Khan
• Sarah Khan
• Anna Khanafer, PHARMD

• Psychiatric/Mental Health Nurse Practitioner in Canton, MI
• Providers in Canton, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.