KHADER AHMAD ZAHDAN (DO) – Emergency Medicine Physician, NPI 1023696572

KHADER AHMAD ZAHDAN (DO) is a healthcare provider. based in Jackson, Michigan. specializing in EMERGENCY MEDICINE. They hold the professional credentials DO. They hold a License No. 036173368 (IL). The NPI Number for KHADER AHMAD ZAHDAN (DO) is 1023696572

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
KHADER AHMAD ZAHDAN (DO)
NPI
1023696572
Phone
Not provided
Address
205 N EAST AVE
Enumeration Date
29 March 2021
Last Update Date
5 April 2025

Doctor Profile

Medical School Name
NEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
Secondary Phone
7089235800
Graduation Year
2021 (5 years ago)
PAC ID
8628578374
Group Practice PAC ID
1052578366
Professional Enrollment ID
I20250826002683
Address ID
IL604631290PA12251AVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness75
Years active:5State licenses:1Digital endpointsOther names

3,157 EMERGENCY MEDICINE in MI

Provider Addresses for KHADER AHMAD ZAHDAN (DO)

  • 205 N EAST AVE

    JACKSON, MI 492011753

    Phone:

    Mailing address matches the actual address.

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: 2025-08-26

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
I20250826002683IEmergency MedicineILTBD

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 49201)

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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: 1052578366View full group profile
NameSpecialtyState
Emergency MedicineIN
Emergency MedicineIL
Emergency MedicineIL
Emergency MedicineIL
Nurse PractitionerIL
-IL
Emergency MedicineIL
Emergency MedicineIL
Emergency MedicineIL
Emergency MedicineIL

Reviews

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Frequently asked questions

What is KHADER AHMAD ZAHDAN (DO)'s NPI number?
KHADER AHMAD ZAHDAN (DO)'s NPI is 1023696572 — the number used across U.S. healthcare to identify this provider.
Is there an active status for KHADER AHMAD ZAHDAN (DO)?
For scheduling context, KHADER AHMAD ZAHDAN (DO) is shown as active in the registry.
What kind of doctor is KHADER AHMAD ZAHDAN (DO)?
KHADER AHMAD ZAHDAN (DO) is associated with Emergency Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
Is KHADER AHMAD ZAHDAN (DO) associated with Jackson?
Public fields place KHADER AHMAD ZAHDAN (DO) around Jackson, Michigan. Always confirm the exact site before visiting.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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