Individual provider Active NPI

Sara Khan, PA-C

  • Medical Physician Assistant
  • Poughquag, NY
National Provider Identifier
1013458108
Registry record updated Mar 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
020693 Issued in NY
Practice address
444 Depot Hill Rd
Poughquag, NY 12570-5766
Phone
(845) 724-1292
NPI assigned
Mar 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 020693 NY Primary

Addresses

Primary practice location

444 Depot Hill Rd
Poughquag, NY 12570-5766

Mailing address

444 Depot Hill Rd
Poughquag, NY 12570-5766
Phone (845) 724-1292

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190806002320 NY Practitioner - Physician Assistant 6800123472 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercy College, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson Valley Cardiovascular Practice PCGroup PAC ID 0244467181, 67 clinicians

Practice addresses (Care Compare)

1 Columbia St
Poughkeepsie, NY 12601-3924

670 Stoneleigh Ave
FL 1
Carmel, NY 10512-3997
Phone (845) 228-2910

Hospital & facility affiliations

  • Vassar Brothers Medical Center Hospital, Poughkeepsie, NY, CCN 330023
  • Northern Dutchess Hospital Hospital, Rhinebeck, NY, CCN 330049
  • Sharon Hospital Hospital, Sharon, CT, CCN 070004
  • Montefiore St Luke'S Cornwall Hospital, Newburgh, NY, CCN 330264
  • Healthalliance Hospital Marys Avenue Campus Hospital, Kingston, NY, CCN 330224

Merit-based Incentive Payment System (MIPS)

Final score
78.69 of 100Reported as group
Quality
54.12
Promoting interoperability
98
Improvement activities
40
Cost
76.5

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
020693NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince Jun 12, 2019 Accepting new patients
Montefiore Medical Center CurrentSince Jun 12, 2019 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

Interoperability endpoints

  • Direct secure messaging: skhan3@montefioredirect.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1013458108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 DEPOT HILL RD",
            "city": "POUGHQUAG",
            "state": "NY",
            "postal_code": "125705766",
            "telephone_number": "845-724-1292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 DEPOT HILL RD",
            "city": "POUGHQUAG",
            "state": "NY",
            "postal_code": "125705766",
            "telephone_number": "845-724-1292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SARA",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-09",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "020693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poughquag, NY

Sources for this page

Verify at the official NPI Registry.