DR. SHEEMA KHAN M.D.
NPI 1609186360
Obstetrics & Gynecology - Obstetrics in Marietta, GA

NPI Status: Active since October 15, 2010

Contact Information

699 CHURCH ST NE
STE 220
MARIETTA, GA
ZIP 30060
Phone: (770) 422-8505
Fax: (770) 424-7449

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  • Individual
  • Female
  • Years of Experience 16
  • Obstetrics & Gynecology
  • Obstetrics
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting

About SHEEMA KHAN

This page provides the complete NPI Profile along with additional information for Sheema Khan, a women's health care provider established in Marietta, Georgia with a medical specialization in Obstetrics & Gynecology, focusing in obstetrics and more than 16 years of experience. The healthcare provider is registered in the NPI registry with number 1609186360 assigned on October 2010. The practitioner's primary taxonomy code is 207VX0000X with license number 72350 (GA). The provider is registered as an individual and her NPI record was last updated 12 years ago.

NPI
1609186360
Provider Name
DR. SHEEMA KHAN M.D.
Gender
Female
Entity Type
Individual
Location Address
699 CHURCH ST NE STE 220 MARIETTA, GA 30060
Location Phone
(770) 422-8505
Location Fax
(770) 424-7449
Mailing Address
699 CHURCH ST NE STE 220 MARIETTA, GA 30060
Mailing Phone
(770) 422-8505
Mailing Fax
(770) 424-7449
Medical School Name
OTHER
Graduation Year
2010
Is Sole Proprietor?
No
Enumeration Date
10-15-2010
Last Update Date
10-14-2014
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Women's health care providers like Sheema Khan treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Obstetrics & Gynecology Obstetrics

Taxonomy Code
207VX0000X
Type
Allopathic & Osteopathic Physicians
License No.
72350
License State
GA
Taxonomy Description
A physician who specializes in diagnosis, treatment, and management of patients with obstetric conditions. Source: National Uniform Claim Committee

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • SoloCare Bronze EPO $8500 DED HSA 10004 - EPO
  • SoloCare Exp Bronze EPO $9500 DED 10015 - EPO
  • SoloCare Gold EPO $1500 DED 10010 - EPO
  • SoloCare Silver EPO $5000 DED 10014 - EPO
  • SoloCare Silver EPO $6500 DED 10013 - EPO
  • SoloCare Standard Exp Bronze EPO $7500 DED 10008 - EPO
  • SoloCare Standard Gold EPO $2000 DED 10006 - EPO
  • SoloCare Standard Platinum EPO $0 DED 10005 - EPO
  • SoloCare Standard Silver EPO $6000 DED 10007 - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
003149603AMEDICAID (05)GA 

Medicare Participation & PECOS Enrollment Status

Sheema Khan is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Sheema Khan is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 7810118734

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20141017001821

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Cervical or vaginal cancer screening; pelvic and clinical breast examination

This procedure involves checking for health issues in the lower abdomen and chest area. It helps identify early signs of certain conditions, increasing the chance for successful treatment. It's a routine check-up that's important for maintaining good health.

This service was performed 15 times for 15 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $32.66 for a new patient copayment and $17.71 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 30060 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $130.64
  • Minimum New Patient Price $56.84
  • Maximum New Patient Price $172.43
  • Average New Patient Copayment $32.66
  • Minimum New Patient Copayment $14.21
  • Maximum New Patient Copayment $43.1

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $70.85
  • Minimum Established Patient Price $18.22
  • Maximum Established Patient Price $140.4
  • Average Established Patient Copayment $17.71
  • Minimum Established Patient Copayment $4.55
  • Maximum Established Patient Copayment $35.1

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

MIPS Quality Measures

The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.

Quality Measure Performance Number of Patients
Breast Cancer Screening 87% 273
Cervical Cancer Screening 97% 1620
Controlling High Blood Pressure 74% 23
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 29% 1352
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented 46% 2151
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 93% 1685
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 13% 60
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 96% 1685

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Sheema Khan is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
WELLSTAR KENNESTONE REGIONAL MEDICAL CENTER677 CHURCH STREET
MARIETTA, GA 30060
(770) 793-5000Acute Care Hospitals
WELLSTAR PAULDING MEDICAL CENTER2518 JIMMY LEE SMITH PARKWAY
HIRAM, GA 30141
(470) 644-7000Acute Care Hospitals
WELLSTAR COBB MEDICAL CENTER3950 AUSTELL RD
AUSTELL, GA 30106
(770) 732-4000Acute Care Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1609186360, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
0
Doubled → 0
Pos 4
9
Unchanged
Pos 5
1
Doubled → 2
Pos 6
8
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
3
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 0 → 0 1 → 2 6 → 12 → 3 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 0 + 9 + 2 + 8 + 1 + 2 + 3 + 1 + 2 + 24 = 60

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 60 is 60. The difference is the calculated check digit.

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1609186360.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Obstetrics & Gynecology
699 CHURCH ST NE, SUITE 500
MARIETTA, GA 30060
Obstetrics & Gynecology
699 CHURCH ST NE, SUITE 220
MARIETTA, GA 30060
Nurse Practitioner (Women's Health)
699 CHURCH ST NE, SUITE 220
MARIETTA, GA 30060
Obstetrics & Gynecology
699 CHURCH ST NE, SUITE 220
MARIETTA, GA 30060
Obstetrics & Gynecology
699 CHURCH ST NE, SUITE 220
MARIETTA, GA 30060
Internal Medicine (Cardiovascular Disease)
699 CHURCH ST NE, SUITE 240
MARIETTA, GA 30060
Obstetrics & Gynecology
699 CHURCH ST NE, SUITE 300
MARIETTA, GA 30060
Obstetrics & Gynecology
699 CHURCH ST NE, SUITE 500
MARIETTA, GA 30060
Obstetrics & Gynecology
699 CHURCH ST NE, SUITE 500
MARIETTA, GA 30060
Obstetrics & Gynecology
699 CHURCH ST NE, SUITE 300
MARIETTA, GA 30060
Obstetrics & Gynecology
699 CHURCH ST NE, SUITE 300
MARIETTA, GA 30060
Obstetrics & Gynecology
699 CHURCH ST NE, SUITE 300
MARIETTA, GA 30060
Obstetrics & Gynecology
699 CHURCH ST NE, SUITE 300
MARIETTA, GA 30060
Obstetrics & Gynecology
699 CHURCH ST NE, SUITE 300
MARIETTA, GA 30060
Advanced Practice Midwife
699 CHURCH ST NE, SUITE 500
MARIETTA, GA 30060
Audiologist
699 CHURCH ST NE, SUITE 340
MARIETTA, GA 30060
Nurse Practitioner (Obstetrics & Gynecology)
699 CHURCH ST NE, SUITE 300
MARIETTA, GA 30060
Obstetrics & Gynecology
699 CHURCH ST NE, STE 220
MARIETTA, GA 30060
Audiologist
699 CHURCH ST NE, SUITE 340
MARIETTA, GA 30060
Advanced Practice Midwife
699 CHURCH ST NE, SUITE 300
MARIETTA, GA 30060

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1609186360, enumerated as an "individual" on October 15, 2010.

The provider is located at 699 CHURCH ST NE STE 220 MARIETTA, GA 30060 and the phone number is (770) 422-8505.

Obstetrics & Gynecology with taxonomy code 207VX0000X and a focus in Obstetrics.

The provider might be accepting Accepts: Alliant Health Plans, Inc., Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.

Sheema Khan is affiliated with: WELLSTAR KENNESTONE REGIONAL MEDICAL CENTER, WELLSTAR PAULDING MEDICAL CENTER and WELLSTAR COBB MEDICAL CENTER.