SHAMAILA A KHAN (PHD) – Clinical Psychologist, NPI 1023212768

SHAMAILA A KHAN (PHD) is a healthcare provider. based in Boston, Massachusetts. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 10413 (MA). The NPI Number for SHAMAILA A KHAN (PHD) is 1023212768

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
SHAMAILA A KHAN (PHD)
NPI
1023212768
Phone
Not provided
Address
720 HARRISON AVE
Enumeration Date
14 June 2007
Last Update Date
8 January 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6174145245
Graduation Year
2010 (16 years ago)
PAC ID
3779854682
Group Practice PAC ID
7911805361
Professional Enrollment ID
I20170810000443
Address ID
MA021182908BO1XXXXPLXX500
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience55
Completeness75
Years active:18State licenses:1Digital endpointsOther names

1,694 CLINICAL PSYCHOLOGIST in MA

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Provider Addresses for SHAMAILA A KHAN (PHD)

  • Doctors Office Building, 720, Harrison Avenue, South End, Boston, Suffolk County, Massachusetts, 02118, United States

    DOB 503

    BOSTON, MA 021182371

    Phone:

    Type: Mailing

  • Boston Medical Center, 1, Massachusetts Avenue, South End, Boston, Suffolk County, Massachusetts, 02118, United States

    BOSTON, MA 021182908

    Phone: (617) 414-5245

    Type: Location

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: 2017-08-10

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
I20170810000443IClinical PsychologistMATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02118)

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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: 7911805361View full group profile

Reviews

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Frequently asked questions

What is SHAMAILA A KHAN (PHD)'s NPI number?
SHAMAILA A KHAN (PHD)'s NPI is 1023212768 — the number used across U.S. healthcare to identify this provider.
Is SHAMAILA A KHAN (PHD) shown as active in public data?
Registry records indicate SHAMAILA A KHAN (PHD) maintains an active NPI.
What expertise is attributed to SHAMAILA A KHAN (PHD)?
SHAMAILA A KHAN (PHD)'s specialty line reads Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Is SHAMAILA A KHAN (PHD) located near Boston?
SHAMAILA A KHAN (PHD) currently maps to Boston, Massachusetts in this extract.
Can I trust this NPI listing for SHAMAILA A KHAN (PHD)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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