Dewan S Khan M.D. PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MA61758 Issued in NJ

Legal business name

DEWAN S KHAN M.D. PC

Practice address

146 New Brunswick Ave
Hopetown, NJ 08861

Phone

(732) 697-1919

Fax

(800) 954-0789

NPI assigned

Dec 1, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Dewan S Khan, M.D.NPI 1306914825

Title

Owner

Phone

(732) 697-1919

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dewan Khan, MD

  • Internal Medicine Physician
  • Hopelawn, NJ
  • NPI 1306914825
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343865600000",
    "number": "1104994649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7438",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "08816",
            "telephone_number": "732-697-1919",
            "fax_number": "800-954-0789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 NEW BRUNSWICK AVE",
            "city": "HOPETOWN",
            "state": "NJ",
            "postal_code": "08861",
            "telephone_number": "732-697-1919",
            "fax_number": "800-954-0789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEWAN S KHAN M.D. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2012-08-02",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "DEWAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-697-1919",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA61758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7067801",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.