Individual provider Active NPI

Stephanie Khan, RN

  • Pediatric Registered Nurse
  • Monsey, NY
National Provider Identifier
1184268401
Registry record updated Oct 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
775387 Issued in NY
Practice address
25 Margetts Rd
Monsey, NY 10952-5023
Phone
(845) 577-6190
NPI assigned
Oct 30, 2019
Last updated
Oct 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 775387 NY Primary

Addresses

Primary practice location

25 Margetts Rd
Monsey, NY 10952-5023

Mailing address

9 Rake St Apt 1
Harriman, NY 10926-3247
Phone (914) 258-4362

Other identifiers 1

IdentifierTypeStateIssuer
140996425MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
775387NYMDPediatric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1184268401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 RAKE ST APT 1",
            "city": "HARRIMAN",
            "state": "NY",
            "postal_code": "109263247",
            "telephone_number": "914-258-4362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MARGETTS RD",
            "city": "MONSEY",
            "state": "NY",
            "postal_code": "109525023",
            "telephone_number": "845-577-6190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "STEPHANIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "NY",
            "license": "775387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140996425",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monsey, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.