Active NPI
Mahjabeen Ahmed Khan, MD
- Neurology with Special Qualifications in Child Neurology Physician
- Orlando, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology with Special Qualifications in Child Neurology Physician
- License
- ME169609
- 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, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
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
| License | State | Type | Specialty |
|---|---|---|---|
| ME169609 | FL | MD | Neurology with Special Qualifications in Child Neurology Physician |
| 2018016195 | MO | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orlando Health Medical Group Inc | Current | Accepting new patients | |
| Orlando Health Medical Group Inc | Current | 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.
-
- Internal Medicine Physician
- Orlando, FL
- NPI 1669429577
-
- Durable Medical Equipment & Medical Supplies
- Winter Park, FL
- NPI 1265019541
-
dba SSM Health Medical Group
- Durable Medical Equipment & Medical Supplies
- Fenton, MO
- NPI 1124579966
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.