Active NPI
Jibran Khan, M.D.
- Internal Medicine Physician
- Woonsocket, RI
National Provider Identifier
1902803935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 9516
- Practice address
- 20 Cumberland Hill Rd
Suite 208
Woonsocket, RI 02895-4854 - Phone
- (401) 765-1200
- Fax
- (401) 765-1212
- NPI assigned
- Jul 6, 2005
- Last updated
- Apr 1, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 9516 | RI | Primary |
Addresses
Primary practice location
20 Cumberland Hill Rd
Suite 208
Woonsocket, RI 02895-4854
Mailing address
3 Shady Rose LN
Manville, RI 02838-1044
Phone (401) 765-1200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9020479 | Medicaid | RI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
20 Cumberland Hill Rd
Unit 208
Woonsocket, RI 02895-4854
Phone (401) 765-1200
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9516 | RI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ocean Medical Practice, Inc. | Internal Medicine | Current | Accepting new patients |
| Frederick Health Hospital Inc | Past | Accepting new patients | |
| Cai Internal Medicine | Internal Medicine | Past | Accepting new patients |
| Cardiology Associates, Inc. | Past | Accepting new patients |
Locations
20 Cumberland Hill Rd
Unit 208
Woonsocket, RI 02895
Phone (401) 765-1200
Interoperability endpoints
- jkhan@direct.carene.org
Organizations & group practices 4
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.
-
- Internal Medicine Physician
- Woonsocket, RI
- NPI 1043401979
-
- Internal Medicine Physician
- Woonsocket, RI
- NPI 1558409342
-
- Specialist
- Woonsocket, RI
- NPI 1649384355
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Landmark Medical Center
- General Acute Care Hospital
- Woonsocket, RI
- NPI 1699752923
-
dba Landmark Medical Center
- Psychiatric Hospital Unit
- Woonsocket, RI
- NPI 1396722666
-
- General Acute Care Hospital
- Providence, RI
- NPI 1487649430
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207008000000",
"number": "1902803935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 SHADY ROSE LN",
"city": "MANVILLE",
"state": "RI",
"postal_code": "028381044",
"telephone_number": "401-765-1200",
"fax_number": "410-765-1212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 CUMBERLAND HILL RD",
"address_2": "SUITE 208",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028954854",
"telephone_number": "401-765-1200",
"fax_number": "401-765-1212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "JIBRAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-06",
"last_updated": "2008-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "RI",
"license": "9516",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9020479",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Woonsocket, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; 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.