Ayesha Hasan Khan, D.O.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

H0088396 Issued in MD

Practice address

14201 Laurel Park Dr Ste 215
Laurel, MD 20707-5260

Phone

(240) 690-2828

NPI assigned

Jun 28, 2013

Last updated

Dec 29, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 16, 2020 through Mar 16, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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

• Ayesha Khan DO, LLC

  • Psychiatry Physician
  • Laurel, MD
  • NPI 1174153522
  NPD Authorized official

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

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1093155475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19328 ERIN TREE CT",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208794973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14201 LAUREL PARK DR STE 215",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075260",
            "telephone_number": "240-690-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "AYESHA",
        "middle_name": "HASAN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-28",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MI",
            "license": "5101020462",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MD",
            "license": "H0088396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keys Development Ta
• Keystone Healthcare Services LLC
• Aliyah Khalifa
• Evelyn Celestina Khama
• Atiya Batool Khan, MD
• Nazia R Khan, PHARMD
• Sharareh Khanjani
• Elke Rifuh Khen
• Nadia Khoury, DPT
• Da Rye Kim, L.AC

• Psychiatry Physician in Laurel, MD
• Providers in Laurel, MD by specialty
• Psychiatry Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.