Individual provider Active NPI

Radia Wali Khan, M.D.

  • Internal Medicine Physician
  • Sacramento, CA
National Provider Identifier
1952411084
Registry record updated Jan 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
40096 Issued in KY
Practice address
1020 29TH St Ste 480
Sacramento, CA 95816-5173
Phone
(916) 733-3777
Fax
(916) 454-6780
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 40096 KY Primary

Addresses

Primary practice location

1020 29TH St Ste 480
Sacramento, CA 95816-5173

Mailing address

10470 Old Placerville Rd
Suite 100
Sacramento, CA 95827-2539
Phone (855) 771-0335

Other practice location 1

222 Medical Cir
Morehead, KY 40351-1179
Phone (606) 783-6522

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
I20070612000387 CA Practitioner - Internal Medicine 8224136403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

1 Medical Plaza Dr
Roseville, CA 95661-3037
Phone (916) 454-6868

2800 L St
Sacramento, CA 95816-5616

2825 Capitol Ave
Sacramento, CA 95816-6039
Phone (916) 454-6600

Hospital & facility affiliations

  • Sutter Care at Home Hospice, Roseville, CA, CCN 051652
  • Sutter Medical Center, Sacramento Hospital, Sacramento, CA, CCN 050108

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40096KYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation Internal Medicine Current Accepting new patients
Sutter North Medical Foundation Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Sutter West Bay Medical Foundation Internal Medicine Past Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: rkhanmd13845@hisp.ehr.sutterhealth.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.

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1952411084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10470 OLD PLACERVILLE RD",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272539",
            "telephone_number": "855-771-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 29TH ST STE 480",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165173",
            "telephone_number": "916-733-3777",
            "fax_number": "916-454-6780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 Medical Cir",
            "address_purpose": "LOCATION",
            "city": "Morehead",
            "state": "KY",
            "postal_code": "403511179",
            "country_code": "US",
            "telephone_number": "606-783-6522",
            "fax_number": "606-783-6904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "RADIA",
        "middle_name": "WALI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "40096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.