Individual provider Active NPI

Ali Khalid, MD

  • Family Medicine Physician
  • Eldersburg, MD
National Provider Identifier
1912586652
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0101166 Issued in MD
Practice address
1380 Progress Way Ste 114
Eldersburg, MD 21784-6499
Phone
(410) 795-2233
NPI assigned
Apr 7, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X D0101166 MD Primary

Addresses

Primary practice location

1380 Progress Way Ste 114
Eldersburg, MD 21784-6499

Mailing address

1380 Progress Way Ste 114
Eldersburg, MD 21784-6499
Phone (410) 795-2233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20240926000172 MD Practitioner - Family Practice 7911448238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agape Physical Therapy and Sports Rehabilitation LPGroup PAC ID 3870741390, 684 clinicians
Carroll Primary Care, PAGroup PAC ID 2668447533, 7 clinicians

Practice addresses (Care Compare)

12 Newport Dr
Suite a
Forest Hill, MD 21050-1758

1380 Progress Way
Suite 114
Eldersburg, MD 21784-6499
Phone (410) 795-2233

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0101166MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carroll Primary Care, PA Family Medicine CurrentSince Sep 3, 2024 Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1380 Progress Way
Ste 114
Sykesville, MD 21784
Phone (410) 795-1888

912 Washington Rd
Westminster, MD 21157
Phone (301) 848-4121

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1912586652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 PROGRESS WAY STE 114",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846499",
            "telephone_number": "410-795-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 PROGRESS WAY STE 114",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846499",
            "telephone_number": "410-795-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALID",
        "first_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-07",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0101166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eldersburg, MD

Sources for this page

Verify at the official NPI Registry.