Wardah Zia Khan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

313402 Issued in NY

Practice address

75 N Country Rd
Port Jefferson, NY 11777-2190

Phone

(631) 686-2517

Fax

(631) 686-7651

NPI assigned

Aug 21, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Internal Medicine

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Long Island Jewish Medical Center Hospital, New Hyde Park, NY, CCN 330195

Merit-based Incentive Payment System (MIPS)

Final score

93.07 of 100Reported as apm

Quality

79.77

Promoting interoperability

88.77

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

93.07 of 100Reported as apm

Quality

79.77

Promoting interoperability

88.77

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678

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.

• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Harbor View Medical Services PC

  • Pulmonary Disease Physician
  • Port Jefferson, NY
  • NPI 1861636219
  Medicare reassignment NPD
• John T. Mather Memorial Hospital

  • Psychiatry Physician
  • Port Jefferson Station, NY
  • NPI 1376642371
  Medicare reassignment NPD
• Harbor View Medical Services PC

  • Internal Medicine Physician
  • Port Jefferson, NY
  • NPI 1306631742
  NPD
• Harbor View Medical Services PC

  • Internal Medicine Physician
  • Port Jefferson, NY
  • NPI 1831487198
  NPD
• John T. Mather Memorial Hospital

  • Critical Care Medicine (Internal Medicine) Physician
  • Port Jefferson, NY
  • NPI 1467249334
  NPD
• John T. Mather Memorial Hospital

  • Hospitalist Physician
  • Port Jefferson, NY
  • NPI 1932296316
  NPD
• North Shore - Lij Medical PC

  • Internal Medicine Physician
  • New Hyde Park, NY
  • NPI 1790043479
  NPD
• Long Island Jewish Medical Center

  • General Acute Care Hospital
  • New Hyde Park, NY
  • NPI 1285641514
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Long Island Jewish Medical Center

  • General Acute Care Hospital
  • New Hyde Park, NY
  • NPI 1285641514
  Care Compare affiliation

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1124508965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 ROUTE 112",
            "address_2": "BUILDING 6, SUITE A",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "11776",
            "telephone_number": "631-686-1413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 N COUNTRY RD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772190",
            "telephone_number": "631-686-2517",
            "fax_number": "631-686-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "WARDAH",
        "middle_name": "ZIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-21",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "313402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anjali Kewalramani
• Muhammad Jahanzaib Khan
• Samiha Tasnim Khan, DO, MD, MPH
• Sumer Khan
• Umair Khan
• Kim Tassinari Mental Health Counseling, PLLC
• Christopher Kim, DO
• Joseph Kiho Kim, MD
• Misook Kim
• Ted Ilhyun Kim

• Internal Medicine Physician in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.