Individual provider Active NPI

Rubana Khan, DO

  • Family Medicine Physician
  • Columbia, PA
National Provider Identifier
1013578608
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101026334 Issued in MI
Practice address
3985 Columbia Ave
Columbia, PA 17512-9037
Phone
(717) 285-3144
NPI assigned
Jun 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X BP10069235 MI
Family Medicine Physician 207Q00000X 5101026334 MI Primary

Addresses

Primary practice location

3985 Columbia Ave
Columbia, PA 17512-9037

Mailing address

6543 Shoreline Dr
Troy, MI 48085-1056

Other practice location 1

5323 Harry Hines Blvd
Dallas, TX 75390-7201
Phone (832) 798-0399

Other practice location 2

205 N East Ave
Jackson, MI 49201-1753
Phone (810) 931-5407

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240422000920 PA Practitioner - Family Practice 7315386521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
William Carey University College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Penn State Health Medical Group LLCGroup PAC ID 8729351077, 720 clinicians

Practice addresses (Care Compare)

3985 Columbia Ave
Columbia, PA 17512-9003
Phone (717) 285-3144

Hospital & facility affiliations

  • Penn State Health St. Joseph Hospital, Reading, PA, CCN 390096
  • Milton S Hershey Medical Center Hospital, Hershey, PA, CCN 390256
  • Lancaster General Hospital Hospital, Lancaster, PA, CCN 390100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101026334MIMDFamily Medicine Physician
BP10069235MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Penn State Health Medical Group, LLC Current Accepting new patients
Penn State Health Medical Group, LLC CurrentSince May 6, 2024 Accepting new patients
Penn State Health Medical Group, LLC CurrentSince May 6, 2024 Accepting new patients
Penn State Health Medical Group, LLC Family Medicine Past Accepting new patients
Penn State Health Medical Group, LLC Past Accepting new patients

Locations

3985 Columbia Ave
Columbia, PA 17512
Phone (717) 285-3144

3985 Columbia Ave
Ste 8
Columbia, PA 17512
Phone (717) 285-3144

1120 Cocoa Ave
Hershey, PA 17033
Phone (717) 533-4141

Organizations & group practices 5

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 5

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": "1561334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1013578608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6543 SHORELINE DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480851056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3985 COLUMBIA AVE",
            "city": "COLUMBIA",
            "state": "PA",
            "postal_code": "175129037",
            "telephone_number": "717-285-3144"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5323 Harry Hines Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "753907201",
            "country_code": "US",
            "telephone_number": "832-798-0399",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 N East Ave",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492011753",
            "country_code": "US",
            "telephone_number": "810-931-5407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "RUBANA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-24",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "BP10069235",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101026334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, PA

Sources for this page

Verify at the official NPI Registry.