Individual provider Active NPI

Reja Khan, PA-C

  • Physician Assistant
  • Washington, DC
National Provider Identifier
1164896569
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA031570 Issued in DC
Practice address
1350 Connecticut Ave NW Ste 1250
Washington, DC 20036-1728
Phone
(202) 627-1901
Fax
(202) 660-0025
NPI assigned
Nov 23, 2015
Last updated
Jan 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 7794 GA
Physician Assistant 363A00000X PA031570 DC Primary

Addresses

Primary practice location

1350 Connecticut Ave NW Ste 1250
Washington, DC 20036-1728

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791

Other identifiers 1

IdentifierTypeStateIssuer
20297I1920OtherGAMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160830002401 GA Practitioner - Physician Assistant 6002111986
I20190509000615 DC Practitioner - Physician Assistant 6002111986 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA031570DCMDPhysician Assistant
7794GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aylo Health, LLC Past Accepting new patients
Wendy L Smith M.D. PC Past Accepting new patients
Aylo Health, LLC Past Accepting new patients
Aylo Health, LLC Past Accepting new patients

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1448236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1164896569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791",
            "fax_number": "415-520-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 CONNECTICUT AVE NW STE 1250",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200361728",
            "telephone_number": "202-627-1901",
            "fax_number": "202-660-0025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "REJA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-23",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "7794",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DC",
            "license": "PA031570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "20297I1920",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.