OMAR KHAN (MD) – Diagnostic Radiology Physician, NPI 1104211309

OMAR KHAN (MD) is a healthcare provider. based in Boston, Massachusetts. specializing in DIAGNOSTIC RADIOLOGY. They hold the professional credentials MD. They hold a License No. 281871 (MA). The NPI Number for OMAR KHAN (MD) is 1104211309

Main info

Male
Sole Proprietor
11 Years Of Experience
Accepts Medicare Assignment
Name
OMAR KHAN (MD)
NPI
1104211309
Phone
(617) 726-7717
Address
55 Fruit St # 210
Enumeration Date
3 April 2015
Last Update Date
5 June 2024

Doctor Profile

Medical School Name
WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE
Secondary Phone
9377095051
Graduation Year
2015 (11 years ago)
PAC ID
8022322791
Group Practice PAC ID
9537060470
Professional Enrollment ID
I20250512001352
Address ID
IL605173992WO3540XPLXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience55
Completeness75
Years active:11State licenses:2Digital endpointsOther names

1,897 DIAGNOSTIC RADIOLOGY in MA

Provider Addresses for OMAR KHAN (MD)

  • 55 Fruit St # 210

    Boston, MA 021142696

    Phone: (617) 726-7717

    Type: Location

  • 870 SOUTHWICK CIRCLE

    DAYTON, OH 45459

    Phone:

    Type: Mailing

  • 55 FRUIT ST # 210

    BOSTON, MA 021142696

    Phone: (617) 726-7717

    Type: Location

  • PO BOX 750243

    DAYTON, OH 454750243

    Phone: (937) 709-5051

    Fax: (937) 709-5050

    Type: Mailing

  • 1 WYOMING ST

    DAYTON, OH 454092722

    Phone: (937) 208-3118

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $30.

Total Amount is formed as General ($30) + Research ($0) + Ownership ($0) = $30.

Last reported payment date: 2023-02-22 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($16).

Total Amount

$30

General + Research + Ownership

Payments

2

Total payment records

General Amount

$30

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-02-22

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2025-05-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20210616003204IDiagnostic RadiologyOHTBD
I20250512001352IDiagnostic RadiologyILTBD

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
71045X-ray of chest, 1 view390370$0
70450Ct scan head or brain without contrast202202$0
93971Ultrasound study of one arm or leg veins with compression and maneuvers193189$0
76770Complete ultrasound scan behind abdominal cavity174174$0
73721Mri scan of leg joint without contrast163151$0
View full utilization report →

Insurance plans in this area (ZIP 02114)

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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: 9537060470View full group profile
NameSpecialtyState
Diagnostic Radiology, Addiction MedicineNV
-OH
Diagnostic RadiologyMA
Diagnostic RadiologyFL
Diagnostic RadiologyOH
Diagnostic RadiologyOH
Diagnostic RadiologyWI
Diagnostic RadiologyOH
Diagnostic RadiologyOH
-OH

Reviews

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Frequently asked questions

How do I look up OMAR KHAN (MD) by NPI?
Use NPI 1104211309 when you need to reference OMAR KHAN (MD) in forms, claims, or directories.
Is OMAR KHAN (MD) active in the national directory?
OMAR KHAN (MD)'s public NPI profile is in an active state.
What does OMAR KHAN (MD) treat or focus on?
Patients typically see OMAR KHAN (MD) under the specialty Diagnostic Radiology Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for OMAR KHAN (MD)?
The page summarizes Boston, Massachusetts for OMAR KHAN (MD); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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