Individual provider Active NPI

Maria Khan, M.D.

  • Pediatrics Physician
  • Phoenix, AZ
National Provider Identifier
1063899177
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
56191 Issued in AZ
Practice address
4375 E Irma LN
Phoenix, AZ 85050-4312
Phone
(480) 890-5800
Fax
(480) 890-5920
NPI assigned
Apr 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 56191 AZ Primary

Addresses

Primary practice location

4375 E Irma LN
Phoenix, AZ 85050-4312

Mailing address

4375 E Irma LN
Phoenix, AZ 85050-4312
Phone (480) 890-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20180626000942 AZ Practitioner - Pediatric Medicine 6608181094 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group CurrentSince Nov 25, 2024 Accepting new patients
Banner Childrens Banner Health Clinic LLC Past Accepting new patients
Banner Desert Medical Center Past Accepting new patients

Locations

1625 N Campbell Ave
Ste 3401
Tucson, AZ 85719

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

1625 N Campbell Ave
Tucson, AZ 85719

2167 W Orange Grove Rd
Tucson, AZ 85741
Phone (520) 544-7650

7901 E 22nd St
Tucson, AZ 85710
Phone (520) 694-8400

535 N Wilmot Rd
Ste 101
Tucson, AZ 85711
Phone (520) 694-9988

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1430179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1063899177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 E IRMA LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504312",
            "telephone_number": "480-890-5800",
            "fax_number": "480-890-5920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4375 E IRMA LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504312",
            "telephone_number": "480-890-5800",
            "fax_number": "480-890-5920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MARIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-28",
        "last_updated": "2021-09-03",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "56191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.