Individual provider Active NPI

Qaisar Khan

  • Clinical Psychologist
  • Indianapolis, IN
National Provider Identifier
1932270139
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20041634A Issued in IN
Practice address
8181 Harcourt Rd
Indianapolis, IN 46260-2578
Phone
(800) 257-8715
Fax
(800) 819-1655
NPI assigned
Nov 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 20041634A IN Primary

Addresses

Primary practice location

8181 Harcourt Rd
Indianapolis, IN 46260-2578

Mailing address

1208 Independence Blvd
Plainfield, IN 46168-3270
Phone (317) 839-4661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041110000908 IN Practitioner - Clinical Psychologist 9739142738 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lafayette Pain Care, P.C.Group PAC ID 3678728680, 8 clinicians

Practice addresses (Care Compare)

770 Park E Blvd B
Lafayette, IN 47905-0786
Phone (765) 714-4344

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20041634AINMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lafayette Pain Care PC CurrentSince Feb 27, 2023 Accepting new patients
State of Indiana, Auditor of State CurrentSince Jul 1, 2021 Accepting new patients
Lafayette Pain Care, P.C. CurrentSince Feb 27, 2023 Accepting new patients
State of Indiana, Auditor of State Current Accepting new patients
State of Indiana, Auditor of State CurrentSince Jul 1, 2021 Accepting new patients
Psychological Laboratories of Indianapolis, PC Past Accepting new patients

Locations

107 S Washington St
Ste C
Kokomo, IN 46901
Phone (317) 798-0040

770 Park East Blvd
Ste B
Lafayette, IN 47905
Phone (765) 366-4344

711 Green Rd
Madison, IN 47250
Phone (812) 265-2611

707 N River Dr
Marion, IN 46952
Phone (765) 573-5999

1127 N Western Ave
Marion, IN 46952
Phone (765) 661-2994

1207 E Grace St
Rensselaer, IN 47978
Phone (800) 541-8142

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1163203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932270139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 INDEPENDENCE BLVD",
            "city": "PLAINFIELD",
            "state": "IN",
            "postal_code": "461683270",
            "telephone_number": "317-839-4661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8181 HARCOURT RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602578",
            "telephone_number": "800-257-8715",
            "fax_number": "800-819-1655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "QAISAR",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20041634A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.