Physician Compare National (NPI:1841510294)

HEALTHCARE PROVIDER: ADEEL N KHAN M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1841510294
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8325272883
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20131016001268
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KHAN
	Individual professional last name
Provider First Name	ADEEL
	Individual professional first name
Provider Middle Name	N
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	TEXAS A & M UNIVERSITY SYSTEM, HSC, COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	2009
	Individual professional's medical school graduation year
Primary Specialty	OPHTHALMOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	7900 W JEFFERSON BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 300
	Group Practice or individual's line 2 address
City	FORT WAYNE
	Group Practice or individual's city
State	IN
	Group Practice or individual's state
Zip Code	468044128
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	150017
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	LUTHERAN HOSPITAL OF INDIANA
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	150021
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PARKVIEW REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	150133
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	KOSCIUSKO COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y