Active NPI
Marium Khan, M.D., MPH
- Pulmonary Disease Physician
- Sheboygan, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 70086
- Practice address
- 3400 Union Ave
Sheboygan, WI 53081-8426 - Phone
- (920) 802-2100
- Fax
- (920) 802-1500
- NPI assigned
- Mar 25, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 70086 | WI | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 70086 | WI | |
| Pulmonary Disease Physician | 207RP1001X | 70086 | WI | Primary |
Addresses
Primary practice location
3400 Union Ave
Sheboygan, WI 53081-8426
Mailing address
PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250
Other practice location 1
9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-6850
Other practice location 2
8701 W Watertown Plank Rd
Milwaukee, WI 53226-3548
Phone (414) 805-0532
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922539493 | Medicaid | WI | |
| 100082372 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mkhan313371@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- 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
- Pulmonary Disease
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3400 Union Ave
Sheboygan, WI 53081-8426
Phone (920) 828-2530
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70086 | WI | MD | Critical Care Medicine (Internal Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| The Medical College of Wisconsin, Inc. | Internal Medicine | Current | Accepting new patients |
| Aurora Medical Group, Inc. | Internal Medicine | Current | Accepting new patients |
| Aurora Medical Group, Inc. | Past | Accepting new patients |
Locations
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
3400 Union Ave
Sheboygan, WI 53081
Phone (920) 802-2100
9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000
8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100
Interoperability endpoints
- mkhan313371@direct.myadvocateaurora.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 and National Provider Directory roles.
-
- Certified Registered Nurse Anesthetist
- Milwaukee, WI
- NPI 1427271378
Internal Medicine
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1699720086
-
- Durable Medical Equipment & Medical Supplies
- Oshkosh, WI
- NPI 1326858044
-
- Durable Medical Equipment & Medical Supplies
- Manitowoc, WI
- NPI 1801941075
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Sheboygan, WI
- NPI 1902023955
Hospital
-
dba Aurora Medical Center Sheboygan County
- General Acute Care Hospital
- Sheboygan, WI
- NPI 1922053107
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Cudahy, WI
- NPI 1235355983
Hospital
-
- General Acute Care Hospital
- Milwaukee, WI
- NPI 1861447179
-
dba Aurora at Home
- Community Based Hospice Care Agency
- Green Bay, WI
- NPI 1417110214
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724112000000",
"number": "1922539493",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 735044",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606735044",
"telephone_number": "800-326-2250"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 UNION AVE",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530818426",
"telephone_number": "920-802-2100",
"fax_number": "920-802-1500"
}
],
"practiceLocations": [
{
"address_1": "9200 W Wisconsin Ave",
"address_purpose": "LOCATION",
"city": "Milwaukee",
"state": "WI",
"postal_code": "532263522",
"country_code": "US",
"telephone_number": "414-805-6850",
"fax_number": "414-805-6851",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8701 W Watertown Plank Rd",
"address_purpose": "LOCATION",
"city": "Milwaukee",
"state": "WI",
"postal_code": "532263548",
"country_code": "US",
"telephone_number": "414-805-0532",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KHAN",
"first_name": "MARIUM",
"credential": "M.D., MPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-25",
"last_updated": "2024-08-20",
"certification_date": "2024-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WI",
"license": "70086",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "WI",
"license": "70086",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "WI",
"license": "70086",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1922539493",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100082372",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mkhan313371@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "3400 Union Ave",
"city": "Sheboygan",
"state": "WI",
"country_code": "US",
"postal_code": "530818426",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "3400 Union Ave",
"city": "Sheboygan",
"state": "WI",
"country_code": "US",
"postal_code": "530818426",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Sheboygan, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.