NPIMap

Individual provider Active NPI

Mohammed Q Khan, M.D.

  • Specialist
  • Riverside, CA
National Provider Identifier
1912008087
Registry record updated Apr 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A78544 Issued in CA
Practice address
3595 Van Buren Blvd
Suite #203
Riverside, CA 92503-0311
Phone
(951) 343-1978
Fax
(951) 343-1922
NPI assigned
Sep 25, 2006
Last updated
Apr 22, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2017

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A78544 CA Primary
Internal Medicine Physician 207R00000X A78544 CA
Nephrology Physician 207RN0300X A78544 CA

Addresses

Primary practice location

3595 Van Buren Blvd
Suite #203
Riverside, CA 92503-0311

Mailing address

3595 Van Buren Blvd
Ste 203
Riverside, CA 92503-0311
Phone (951) 343-1978

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20071222000047 CA Practitioner - NephrologyPractitioner - Internal Medicine 4789774183 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Riverside Nephrology Physicians IncGroup PAC ID 9335271147, 3 clinicians

Practice addresses (Care Compare)

2224 Medical Ctr Dr
Perris, CA 92571-2638
Phone (951) 436-3535

3595 Van Buren Blvd
Suite 203
Riverside, CA 92503-0311

3865 Jackson St
Riverside, CA 92503-3919
Phone (951) 688-2211

4445 Magnolia Ave
Riverside, CA 92501-4135
Phone (951) 788-3000

613 S Howard St
Corona, CA 92879-2254
Phone (951) 735-1257

7275 Indiana Ave
Suite 200
Riverside, CA 92504-4543
Phone (951) 343-1978

800 S Main St
Corona, CA 92882-3420
Phone (951) 736-6200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.99 of 100Reported as individual
Quality
89.37
Improvement activities
40
Cost
80.79

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A78544CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Nephrology Physicians Inc Specialist CurrentSince Jul 4, 2010 Accepting new patients
MK Dialysis Center at Riverside, Inc. CurrentSince Mar 28, 2011 Accepting new patients
Mohammed Khan MD Inc Nephrology CurrentSince May 15, 2007 Accepting new patients
Tricity Riverside Dialysis PastSince Mar 15, 2018 Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients
Doctors Hospital of Riverside LLC Past Accepting new patients
Uhs Corona Inc Past Accepting new patients

Locations

613 S Howard St
Corona, CA 92879
Phone (951) 343-1978

3595 Van Buren Blvd
Ste 203
Riverside, CA 92503
Phone (951) 343-1978

7275 Indiana Ave
Riverside, CA 92504
Phone (951) 343-1978

7275 Indiana Ave
Ste 200
Riverside, CA 92504
Phone (951) 343-1978

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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.

Hospital & facility affiliations 7

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492819200000",
    "number": "1912008087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3595 VAN BUREN BLVD",
            "address_2": "STE 203",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925030311",
            "telephone_number": "951-343-1978",
            "fax_number": "951-343-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3595 VAN BUREN BLVD",
            "address_2": "SUITE #203",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925030311",
            "telephone_number": "951-343-1978",
            "fax_number": "951-343-1922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MOHAMMED",
        "middle_name": "Q",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2017-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A78544",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A78544",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A78544",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.