DR. QAISER SHAMSHIR KHAN (NPI# 1861806192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861806192 |
| Entity Type | Individual |
| Full Name | DR. QAISER SHAMSHIR KHAN |
| Credential | M.D., MPH |
| Practice Address |
55 Lake Ave N # S7-831 Worcester MA 01655 |
| Mailing Address |
55 Lake Ave N # S7-831 Worcester MA 01655-0002 |
| Practice Telephone | 5088561256 |
| Practice Fax Number | 5088566426 |
| Mailing Telephone | 5088561256 |
| Mailing Fax Number | 5088566426 |
| Enumeration Date | 2014-06-14 |
| Last Update Date | 2018-08-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
274343 | MA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 920 Stanton L Young Blvd, Wp 3440, Oklahoma City, OK 731045036 | 4052718001 | 4052717724 |
| Street Address |
55 LAKE AVE N # S7-831 |
| City | WORCESTER |
| State | MA |
| Zip Code | 01655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205489713 | Darryl Sweeper Jr. | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Psychiatry, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-23 |
| 1225690530 | Ryan Zenevitch | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Family Medicine, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-08 |
| 1932688454 | Victoria Sayeg | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Pediatrics, Worcester, MA 01655 | 2018-08-07 |
| 1114425675 | Judith Dio Wentzell | Social Worker | Umassmemorial Medical Center, 55 Lake Ave North, Dept of Care Coordination, Worcester, MA 01655 | 2018-01-30 |
| 1861927386 | Muhammad Waqas Khan | Student in an Organized Health Care Education/Training Program | University of Massachusetts 55 North Lake Ave, Neurology, Worcester, MA 01655 | 2017-04-21 |
| 1073858981 | Heidi Glover | Nurse Practitioner | 55 Lake Ave North Dept. of Pedi-adolescent, Ummc University Campus, Worcester, MA 01655 | 2012-12-04 |
| 1972867992 | Anna Bjornsdottir | Psychiatry & Neurology | 55 Lake Av N, Worcester, MA 01655 | 2012-06-25 |
| 1245567676 | Steven Edward Mckinley | Nurse Practitioner | 55 Lake Ave. North, Umass Memorial Medical Center University Campus, Worcester, MA 01655 | 2009-11-05 |
| 1851582951 | Robin I Davidson | Neurological Surgery | 55 Lake Ave, North, Ummhc-univ Campus, Worcester, MA 01655 | 2007-08-05 |
| 1184779969 | Bradley Alan Switzer | Internal Medicine | 55 Lake Ave. N, Worrester, MA 01655 | 2007-01-24 |
| Find all providers in zip 01655 | ||||
| Taxonomy Code | 2084P0802X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Psychiatry |
| Addiction Psychiatry is a subspecialty of psychiatry that focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders, and of individuals with dual diagnosis of substance-related and other psychiatric disorders. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245856335 | Mcat LLC | Psychiatry & Neurology | 3 Brighton St, Belmont, MA 02478-4007 | 2020-06-24 |
| 1427673136 | Ronald Bugaoan Md LLC | Psychiatry & Neurology | 225 Water St Ste A140, Plymouth, MA 02360-6248 | 2020-06-09 |
| 1083894059 | Juan R Condemarin | Psychiatry & Neurology | 129 Bigelow St, Brighton, MA 02135-1639 | 2007-11-07 |
| 1548454671 | Alfredo R Chan Md PC | Psychiatry & Neurology | 105 Webster St Ste 6, Hanover, MA 02339-1227 | 2007-08-31 |
| 1669666947 | John Dmochowski, Md PC | Psychiatry & Neurology | 31 Meltiah Rd, Falmouth, MA 02540-1843 | 2007-08-30 |
| 1093876609 | Robert Long Kelley | Psychiatry & Neurology | 20 Hope Ave Suite 201, Waltham, MA 20453 | 2006-12-13 |
| 1306896527 | Ethan Samuel Rofman | Psychiatry & Neurology | 123 Grant Ave, Newton Centre, MA 02459-1350 | 2006-05-10 |
| 1497734768 | Laurence Evans Ducomb | Psychiatry & Neurology | 49 Robinwood Ave, The Arbour Hospital, Jamaica Plain, MA 02130 | 2006-01-13 |
| 1033103247 | Kenneth Minkoff | Psychiatry & Neurology | 100 Powdermill Rd # 319, Acton, MA 01720-5932 | 2005-09-02 |
| 1821565425 | Westborough Professional Associates, LLC | Psychiatry & Neurology | 300 Friberg Pkwy, Westborough, MA 01581-3900 | 2018-11-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.