Individual provider Active NPI

Gauhar R Khan, M.D.

  • Interventional Cardiology Physician
  • Modesto, CA
National Provider Identifier
1922162114
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
A102895 Issued in CA
Practice address
1409 E Briggsmore Ave
Modesto, CA 95355
Phone
(209) 550-4750
Fax
(209) 572-1187
NPI assigned
Dec 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X MD25690 OR
Interventional Cardiology Physician 207RI0011X A102895 CA Primary

Addresses

Primary practice location

1409 E Briggsmore Ave
Modesto, CA 95355

Mailing address

10470 Old Placerville Rd Ste 100
Sacramento, CA 95827-2539
Phone (800) 470-0071

Other practice location 1

1540 Florida Ave Ste 100
Modesto, CA 95350-4430
Phone (209) 577-5557

Other identifiers 2

IdentifierTypeStateIssuer
278082MedicaidOR
P00250897OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20081111000778 CA Practitioner - Cardiovascular Disease (Cardiology) 1951339902 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

1000 Delbon Ave
Turlock, CA 95382-2008
Phone (209) 524-9401

1011 Sylvan Ave
Suite C
Modesto, CA 95350-1693
Phone (209) 550-4780

1409 E Briggsmore Ave
Modesto, CA 95355-2707
Phone (209) 524-1211

1700 Coffee Rd
Modesto, CA 95355-2803
Phone (209) 526-4500

2505 W Hammer LN
Stockton, CA 95209-2839
Phone (209) 957-7050

2545 W Hammer LN
Stockton, CA 95209-2839
Phone (209) 957-7050

2800 L St
Sacramento, CA 95816-5616

441 W Eaton Ave
Tracy, CA 95376-3420
Phone (209) 830-4062

445 W Eaton Ave
Tracy, CA 95376-3420
Phone (209) 524-1211

447 W Eaton Ave
Tracy, CA 95376-3420
Phone (209) 830-4062

473 W Eaton Ave
Tracy, CA 95376-3420
Phone (209) 833-3320

600 Coffee Rd
Modesto, CA 95355-4201
Phone (209) 524-1211

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting41
Pacemaker insertion or repair20
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A102895CAMDInterventional Cardiology Physician
MD25690ORMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation CurrentSince Jul 27, 2019 Accepting new patients
Sutter Valley Medical Foundation CurrentSince Jul 27, 2019 Accepting new patients
Oak Valley Hospital District Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Sutter North Medical Foundation Past Accepting new patients
Doctors Medical Center of Modesto Past Accepting new patients
Doctors Medical Center of Modesto, Inc. Past Accepting new patients
Emanuel Medical Center, Inc. Past Accepting new patients

Locations

600 Coffee Rd
Modesto, CA 95355
Phone (209) 550-4755

1409 E Briggsmore Ave
Modesto, CA 95355
Phone (209) 550-4725

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

2750 Gateway Oaks Dr
Ste 150
Sacramento, CA 95833
Phone (916) 887-7398

10470 Old Placerville Rd
Ste 100
Sacramento, CA 95827

Interoperability endpoints

  • Direct secure messaging: gkhan95639@hisp.ehr.sutterhealth.org

Organizations & group practices 9

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1922162114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "800-470-0071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 E BRIGGSMORE AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95355",
            "telephone_number": "209-550-4750",
            "fax_number": "209-572-1187"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1540 Florida Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953504430",
            "country_code": "US",
            "telephone_number": "209-577-5557",
            "fax_number": "209-579-7246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "GAUHAR",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OR",
            "license": "MD25690",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "CA",
            "license": "A102895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278082",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00250897",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.