Individual provider Active NPI

Sameera Khan, MD

  • Psychiatry Physician
  • Akron, OH
National Provider Identifier
1184710303
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
35059613 Issued in OH
Practice address
340 S Broadway St
Akron, OH 44308-1529
Phone
(330) 253-3100
Fax
(330) 253-5248
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 35059613 OH Primary

Addresses

Primary practice location

340 S Broadway St
Akron, OH 44308-1529

Mailing address

340 S Broadway St
Akron, OH 44308-1529
Phone (330) 253-3100

Other identifiers 1

IdentifierTypeStateIssuer
000000127144OtherOHANTHEM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230829002605 CA Practitioner - Psychiatry 3274709274 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35059613OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Services CurrentSince Aug 1, 2023 Accepting new patients
Hope Services CurrentSince Aug 1, 2023 Accepting new patients
Portage Path Behavioral Health Past Accepting new patients

Locations

1555 Parkmoor Ave
San Jose, CA 95128
Phone (408) 282-0402

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184710303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 S BROADWAY ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081529",
            "telephone_number": "330-253-3100",
            "fax_number": "330-253-5248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 S BROADWAY ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081529",
            "telephone_number": "330-253-3100",
            "fax_number": "330-253-5248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SAMEERA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "35059613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000127144",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.