Individual provider Active NPI

Mahjabeen Ahmed Khan, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Orlando, FL
National Provider Identifier
1972097210
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
ME169609 Issued in FL
Practice address
6150 Metrowest Blvd Ste 105
Orlando, FL 32835-3290
Phone
(321) 842-6671
Fax
(321) 843-6447
NPI assigned
Jun 20, 2018
Last updated
Aug 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 2018016195 MO
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X ME169609 FL Primary

Addresses

Primary practice location

6150 Metrowest Blvd Ste 105
Orlando, FL 32835-3290

Mailing address

6150 Metrowest Blvd Ste 105
Orlando, FL 32835-3290
Phone (321) 842-6671

Other practice location 1

1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone (314) 577-5338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240813000057 FL Practitioner - NeurologyPractitioner - Pediatric Medicine 5395092167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Pediatric Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

6150 Metrowest Blvd
Suite 105
Orlando, FL 32835-3290
Phone (321) 841-3050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME169609FLMDNeurology with Special Qualifications in Child Neurology Physician
2018016195MOMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Aug 1, 2024 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Aug 1, 2024 Accepting new patients
SSM Medical Group Inc. Past Accepting new patients

Locations

100 W Gore St
Ste 600
Orlando, FL 32806
Phone (321) 842-6671

14 W Gore St
Orlando, FL 32806
Phone (321) 841-2500

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

6150 Metrowest Blvd
Ste 105
Orlando, FL 32835
Phone (407) 293-2150

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1972097210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6150 METROWEST BLVD STE 105",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328353290",
            "telephone_number": "321-842-6671",
            "fax_number": "321-843-6447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6150 METROWEST BLVD STE 105",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328353290",
            "telephone_number": "321-842-6671",
            "fax_number": "321-843-6447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1465 S Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631041003",
            "country_code": "US",
            "telephone_number": "314-577-5338",
            "fax_number": "314-268-6411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHMED KHAN",
        "first_name": "MAHJABEEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-20",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": "2018016195",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "FL",
            "license": "ME169609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.