Individual provider Active NPI

Alifia Mansoor Khan, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Evansville, IN
National Provider Identifier
1114185519
Registry record updated Jul 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
01066199A Issued in IN
Practice address
600 Mary St
Pathology Dept.
Evansville, IN 47710-1658
Phone
(812) 450-3344
NPI assigned
Jun 2, 2008
Last updated
Jul 28, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X 0101243655 VA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 01066199A IN Primary

Addresses

Primary practice location

600 Mary St
Pathology Dept.
Evansville, IN 47710-1658

Mailing address

PO Box 3024
Evansville, IN 47730-3024
Phone (800) 467-2392

Other names 1

  • Alifia Manan Vasenwala Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20090715000748 IN Practitioner - Pathology 5991857385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio Valley Pathologists PCGroup PAC ID 3971587973, 12 clinicians

Practice addresses (Care Compare)

600 Mary St
Evansville, IN 47710-1658
Phone (812) 450-5000

617 Oakley St
Evansville, IN 47710-1647
Phone (812) 450-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90 of 100Reported as group
Quality
80
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101243655VAMDCytopathology Physician
01066199AINMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Valley Pathologists PC Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2009 Accepting new patients
Integrated Diagnostic Laboratory, LLC Past Accepting new patients

Locations

600 Mary St
Evansville, IN 47710
Phone (812) 450-2239

4011 Gateway Blvd
Newburgh, IN 47630
Phone (812) 450-2240

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248739200000",
    "number": "1114185519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3024",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477303024",
            "telephone_number": "800-467-2392",
            "fax_number": "812-471-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MARY ST",
            "address_2": "PATHOLOGY DEPT.",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101658",
            "telephone_number": "812-450-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "ALIFIA",
        "middle_name": "MANSOOR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2009-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "VA",
            "license": "0101243655",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": "01066199A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALIFIA",
            "last_name": "VASENWALA",
            "middle_name": "MANAN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.