NPIMap

Individual provider Active NPI

Muhammad Ibrahim Ali Khan, M.D.

  • Internal Medicine Physician
  • Marion, OH
National Provider Identifier
1962448688
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.084940 Issued in OH
Practice address
1073 Harding Memorial Pkwy Ste a
Marion, OH 43302-6364
Phone
(740) 375-8190
Fax
(740) 375-8197
NPI assigned
Jun 21, 2006
Last updated
Dec 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 35084940 OH
Internal Medicine Physician 207R00000X 35.084940 OH Primary

Addresses

Primary practice location

1073 Harding Memorial Pkwy Ste a
Marion, OH 43302-6364

Mailing address

Dept L-3652
Columbus, OH 43260-0001
Phone (740) 375-8190

Other identifiers 1

IdentifierTypeStateIssuer
2499130MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mkhan94293@direct.ohiohealth.com OhioHealth Physician Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040917001116 OH Practitioner - Internal Medicine 9638068836 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Marion Area Physicians LLCGroup PAC ID 1850549437, 179 clinicians

Practice addresses (Care Compare)

1040 Delaware Ave
Marion, OH 43302-6416
Phone (740) 383-7936

1050 Delaware Ave
Marion, OH 43302-6416
Phone (740) 383-7936

1130 Independence Ave
Marion, OH 43302-6318
Phone (740) 383-8591

1138 Independence Ave
Marion, OH 43302-6318
Phone (740) 383-7953

278 Barks Rd W
Marion, OH 43302-7367
Phone (740) 383-7080

921 E Franklin St
Kenton, OH 43326-2020
Phone (800) 282-6741

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35084940OHMDAdult Medicine Physician
35.084940OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marion Area Physicians LLC Internal Medicine CurrentSince Dec 2, 2013 Accepting new patients
Ohiohealth Urgent Care LLC CurrentSince Apr 1, 2020 Accepting new patients
Gamma Center, Inc Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Azad Khan M.D P.C Internal Medicine Past Accepting new patients
Ohiohealth Corporation Internal Medicine Past Accepting new patients

Locations

Dept L3652
Columbus, OH 43260

6905 Hospital Dr
Ste 130
Dublin, OH 43016
Phone (614) 923-0300

2030 Stringtown Rd
Grove City, OH 43123
Phone (614) 566-0987

1040 Delaware Ave
Marion, OH 43302
Phone (330) 256-9874

1050 Delaware Ave
Marion, OH 43302
Phone (740) 383-7038

1073 Harding Memorial Pkwy
Ste A
Marion, OH 43302
Phone (740) 375-8190

1130 Independence Ave
Marion, OH 43302
Phone (740) 383-8591

990 S Prospect St
Ste 3
Marion, OH 43302
Phone (740) 383-7910

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1962448688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT L-3652",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432600001",
            "telephone_number": "740-375-8190",
            "fax_number": "740-375-8197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1073 HARDING MEMORIAL PKWY STE A",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026364",
            "telephone_number": "740-375-8190",
            "fax_number": "740-375-8197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MUHAMMAD",
        "middle_name": "IBRAHIM ALI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "OH",
            "license": "35084940",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.084940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2499130",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkhan94293@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group",
            "address_1": "1130 Independence Ave",
            "city": "Marion",
            "state": "OH",
            "country_code": "US",
            "postal_code": "433026318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marion, OH

Sources for this page

Verify at the official NPI Registry.