KHADIJATU E ALLEN (MD) – Internal Medicine Physician, NPI 1235185455

KHADIJATU E ALLEN (MD) is a healthcare provider. based in Nicholls, Georgia. specializing in Internal Medicine Physician. They hold the professional credentials MD. They hold a License No. 44669 (GA). The NPI Number for KHADIJATU E ALLEN (MD) is 1235185455

Main info

Female
36 Years Of Experience
Accepts Medicare Assignment
Name
KHADIJATU E ALLEN (MD)
NPI
1235185455
Phone
(912) 345-2474
Address
1205 Van Streat Hwy
Enumeration Date
26 May 2006
Last Update Date
15 June 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9126328961
Graduation Year
1990 (36 years ago)
PAC ID
2264423029
Group Practice PAC ID
9335037571
Professional Enrollment ID
I20111115000085
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness75
Years active:20State licenses:1Digital endpointsOther names

Provider Addresses for KHADIJATU E ALLEN (MD)

  • 1205 Van Streat Hwy

    Nicholls, GA 315545025

    Phone: (912) 345-2474

    Fax: (912) 345-5620

    Type: Location

  • 204, East 15th Street, Alma, Bacon County, Georgia, 31510, United States

    ALMA, GA 315102908

    Phone: (912) 632-2952

    Fax: (912) 632-8682

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-11-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20111115000085IInternal MedicineGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making126116$0
99284Emergency department visit with moderate level of medical decision making8376$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only6155$0
View full utilization report →

Insurance plans in this area (ZIP 31554)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9335037571View full group profile
NameSpecialtyState
Family PracticeAL
Emergency MedicineNV
-TN
Family PracticeGA
Emergency Medicine, Internal MedicineGA
Emergency MedicineGA
Family Practice, Emergency MedicineGA
-GA
-GA
Pediatric Medicine, Otolaryngology, Otolaryngology, Emergency Medicine, Pediatric Medicine, Emergency MedicineFL

Reviews

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Frequently asked questions

How do payers reference KHADIJATU E ALLEN (MD)?
For KHADIJATU E ALLEN (MD), use NPI 1235185455 as the unique 10-digit identifier.
Is KHADIJATU E ALLEN (MD) still an active registrant?
KHADIJATU E ALLEN (MD) carries an active NPI according to the public dataset.
What area of care is associated with KHADIJATU E ALLEN (MD)?
KHADIJATU E ALLEN (MD)'s record emphasizes Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Is KHADIJATU E ALLEN (MD) associated with Nicholls?
Public fields place KHADIJATU E ALLEN (MD) around Nicholls, Georgia. Always confirm the exact site before visiting.
What does 3 location(s) imply?
3 practice locations appear in the available data.

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