Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Maryam Idrees Khan, MD

Individual provider Surgery Physician · NPI 1215426440

Maryam Idrees Khan, MD is a Surgical Oncology in Pueblo, Colorado. Qualified in 2018, 8 years ago. Practices with Poudre Valley Medical Group LLC, a 2,416-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in Colorado and New York.

Years since qualifying
8
Licensed in
CO, NY
In the registry since
2018
Specialties on file
5
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1600 N Grand Ave Ste 430
Pueblo, CO 81003-2760
Phone: (719) 545-8240
Fax: (719) 545-4319
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 525 W 15th St Ste 300, Pueblo, CO 81003-2716 — (719) 542-1696
  • 161 Fort Washington Ave Fl 10, New York, NY 10032-3729 — (212) 305-9676

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence DR.0073816 (CO)
Surgery Physician Taxonomy 208600000X · Licence 322450 (NY)
Surgical Oncology Physician Taxonomy 2086X0206X · Licence 322450 (NY)
Surgical Oncology Physician Taxonomy 2086X0206X · Licence DR.0073816 (CO)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1215426440
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 3, 2018
Last updated in NPPESFebruary 27, 2025
Certification dateFebruary 27, 2025
Mailing address1600 N Grand Ave Ste 430, Pueblo, CO 81003-2760

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtySURGICAL ONCOLOGY
Also practisesGENERAL SURGERY
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Poudre Valley Medical Group Llc — 2416 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

Other providers in Pueblo