Individual provider Active NPI

Tanya Tabassum Khan, M.D.

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Austin, TX
National Provider Identifier
1114242922
Registry record updated Jun 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X
License
R0432 Issued in TX
Practice address
5717 Balcones Dr
Austin, TX 78731
Phone
(512) 327-7000
Fax
(512) 314-1662
NPI assigned
Apr 5, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmic Plastic and Reconstructive Surgery Physician 207WX0200X R0432 TX Primary

Addresses

Primary practice location

5717 Balcones Dr
Austin, TX 78731

Mailing address

5717 Balcones Dr
Austin, TX 78731-4203
Phone (512) 327-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20161102000722 TX Practitioner - OphthalmologyPractitioner - Plastic and Reconstructive Surgery 4486872017 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel J Ladd DO PA Ophthalmic Plastic and Reconstructive Surgery CurrentSince May 21, 2019 Accepting new patients
Daniel J Ladd Jr DO PA Dba Austin Center for Skin Health and Rejuvenat Ophthalmic Plastic and Reconstructive Surgery CurrentSince May 21, 2019 Accepting new patients
Eye Clinic of Austin PLLC Past Accepting new patients

Locations

3500 Jefferson St
Ste 200
Austin, TX 78731
Phone (512) 643-4384

3101 Highway 71 E
Ste 203
Bastrop, TX 78602
Phone (512) 643-4384

Organizations & group practices 3

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": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528329600000",
    "number": "1114242922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5717 BALCONES DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314203",
            "telephone_number": "512-327-7000",
            "fax_number": "512-314-1662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5717 BALCONES DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78731",
            "telephone_number": "512-327-7000",
            "fax_number": "512-314-1662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "TANYA",
        "middle_name": "TABASSUM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-05",
        "last_updated": "2018-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0200X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "R0432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.