MARYAM KHALILI DDS-PROSTHODONTIST
NPI 1578101630
Dentist - Prosthodontics in Philadelphia, PA
About Maryam Khalili Dds-prosthodontist NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARYAM KHALILI DDS-PROSTHODONTIST (NPI 1578101630) is an individual prosthodontics provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (DS045634) and active in the NPI registry since December 2019. She is enrolled in Medicare PECOS and maintains a secondary practice location in Philadelphia.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Maryam Khalili Dds-prosthodontist is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Maryam Khalili reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Philadelphia, PA 19140
- Reassigned Medicare billing, Pennsylvania enrollment
- 9 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 19140 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Maryam Khalili's NPI number?
The NPI number for Maryam Khalili is 1578101630. It was assigned to this individual provider in the NPPES registry on December 19, 2019.
Where is Maryam Khalili located?
Maryam Khalili practices at 3223 N Broad St Ofc 314, Philadelphia, PA 19140. The listed phone number is (773) 807-9934.
What is Maryam Khalili's specialty?
The primary specialty registered for this NPI is Dentist, specializing in Prosthodontics, with taxonomy code 1223P0700X.
Is Maryam Khalili enrolled in Medicare?
Yes. Maryam Khalili is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Maryam Khalili's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Maryam Khalili reassigns Medicare benefits to Temple University Of The Commonwealth System Of Higher Education (Philadelphia, PA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Maryam Khalili's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Maryam Khalili accept?
Health plans from Anthem Blue Cross and Blue Shield, Antidote Health Plan of Ohio, Inc., BEST Life, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 14 other insurers list Maryam Khalili as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Maryam Khalili was last updated on May 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Maryam Khalili, DDS-PROSTHODONTIST · NPI 1578101630
Prosthodontics provider in Philadelphia, Pennsylvania. Individual provider, active in the CMS NPPES registry since December 19, 2019.
## Identity
- **NPI:** 1578101630 (Entity type: Individual)
- **Enumerated:** December 19, 2019
- **Primary specialty:** Dentist - Prosthodontics · taxonomy 1223P0700X
- **State license:** DS045634 (Pennsylvania)
- **Sole proprietor:** No
## Practice location
- **Address:** 3223 N BROAD ST OFC 314, Philadelphia, PA 19140-5007
- **Phone:** (773) 807-9934
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Temple University Of The Commonwealth System Of Higher Education (NPI 1912687187, Philadelphia, PA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 21, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1578101630) · Data from the CMS NPPES public registry.