Individual provider Active NPI

Fasiha Khan, DPM

  • Foot & Ankle Surgery Podiatrist
  • Seattle, WA
National Provider Identifier
1174014104
Registry record updated Oct 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
60865235 Issued in WA
Practice address
1660 S Columbian Way
Seattle, WA 98108-1532
Phone
(925) 978-7470
NPI assigned
May 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 60865235 WA Primary

Addresses

Primary practice location

1660 S Columbian Way
Seattle, WA 98108-1532

Mailing address

445 Monarch Hill CT
Keller, TX 76248-9701
Phone (925) 978-7470

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210901003689 TX Practitioner - Podiatry 4183020969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthdrive Podiatry Group PAGroup PAC ID 1759334782, 24 clinicians

Practice addresses (Care Compare)

2413 E Loop 820
Fort Worth, TX 76118-6933
Phone (888) 964-6681

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1785
Removal or shaving of skin growth66

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60865235WAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthdrive Podiatry Group, PA Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540598400000",
    "number": "1174014104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 MONARCH HILL CT",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762489701",
            "telephone_number": "925-978-7470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 S COLUMBIAN WAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981081532",
            "telephone_number": "925-978-7470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "FASIHA",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-24",
        "last_updated": "2018-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "60865235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.