Individual provider Active NPI

Sana Khan, MD

  • Internal Medicine Physician
  • New Haven, CT
National Provider Identifier
1093133290
Registry record updated Oct 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A168289 Issued in CA
Practice address
20 York Street, CB-2041
New Haven, CT 06510
Phone
(203) 688-4748
Fax
(203) 688-4740
NPI assigned
Apr 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 290229 NY
Internal Medicine Physician 207R00000X 56818 CT
Hospitalist Physician 208M00000X 290229 NY
Internal Medicine Physician 207R00000X A168289 CA Primary

Addresses

Primary practice location

20 York Street, CB-2041
New Haven, CT 06510

Mailing address

20 York Street, CB-2041
New Havewn, CT 06510-3220
Phone (203) 688-4748

Other practice location 1

130 Division St
Derby, CT 06418-1326
Phone (203) 732-1330

Other practice location 2

130 Division St
Derby, CT 06418-1326
Phone (203) 732-1330

Other practice location 3

41 E Post Rd
White Plains, NY 10601-4607
Phone (914) 681-2560

Other identifiers 2

IdentifierTypeStateIssuer
56818OtherCTLICENSE
290229OtherNYLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20200807000181 CA Practitioner - HospitalistPractitioner - Internal Medicine 1850696709 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians
Galen Inpatient Physicians PCGroup PAC ID 3678464633, 1,045 clinicians

Practice addresses (Care Compare)

1165 Montgomery Dr
Santa Rosa, CA 95405-4801
Phone (707) 546-3210

250 Bon Air Rd
Greenbrae, CA 94904-1702
Phone (415) 925-7000

Hospital & facility affiliations

  • Marinhealth Medical Center Hospital, Greenbrae, CA, CCN 050360
  • Adventist Health Simi Valley Hospital, Simi Valley, CA, CCN 050236
  • Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A168289CAMDInternal Medicine Physician
56818CTMDInternal Medicine Physician
290229NYMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Aug 3, 2020 Accepting new patients
Galen Inpatient Physicians, PC Hospitalist Current Accepting new patients
Providence Medical Foundation CurrentSince Aug 3, 2020 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Galen Inpatient Physicians PC Hospitalist CurrentSince Dec 10, 2024 Accepting new patients
American Specialty Physicians Group Inc Internal Medicine CurrentSince Aug 14, 2024 Accepting new patients
Galen Inpatient Physicians PC Hospitalist CurrentSince Dec 10, 2024 Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Yale New Haven Hospital Past Accepting new patients
White Plains Hospital Medical Center Past Accepting new patients
Midstate Medical Center Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

151 E Webster St
Ste B
Colusa, CA 95932
Phone (209) 287-6308

250 Bon Air Rd
Kentfield, CA 94904
Phone (415) 464-1350

1125 Sir Francis Drk Blvd
Kentfield, CA 94904
Phone (415) 456-9680

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

700 17th St
Ste 205
Modesto, CA 95354
Phone (209) 248-7851

450 Stanyan St
Fl 6
San Francisco, CA 94117
Phone (415) 456-9680

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

1165 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 525-5300

15248 Eleventh St
Victorville, CA 92395
Phone (760) 245-8691

Organizations & group practices 11

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 3

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": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1093133290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK STREET, CB-2041",
            "city": "NEW HAVEWN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-4748",
            "fax_number": "203-688-4740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK STREET, CB-2041",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06510",
            "telephone_number": "203-688-4748",
            "fax_number": "203-688-4740"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 Division St",
            "address_purpose": "LOCATION",
            "city": "Derby",
            "state": "CT",
            "postal_code": "064181326",
            "country_code": "US",
            "telephone_number": "203-732-1330",
            "fax_number": "203-732-1332",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 Division St",
            "address_purpose": "LOCATION",
            "city": "Derby",
            "state": "CT",
            "postal_code": "064181326",
            "country_code": "US",
            "telephone_number": "203-732-1330",
            "fax_number": "203-732-1332",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "41 E Post Rd",
            "address_purpose": "LOCATION",
            "city": "White Plains",
            "state": "NY",
            "postal_code": "106014607",
            "country_code": "US",
            "telephone_number": "914-681-2560",
            "fax_number": "914-681-2590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-03",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "290229",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "56818",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "290229",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A168289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "56818",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "290229",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.