NPIMap

Individual provider Active NPI

Tanzina Khan, MD, MPH

  • Pain Medicine (Anesthesiology) Physician
  • San Jose, CA
National Provider Identifier
1194959775
Registry record updated Dec 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
A134243 Issued in CA
Practice address
2101 Forest Ave Ste 220a
San Jose, CA 95128-1473
Phone
(408) 295-8628
Fax
(408) 295-8061
NPI assigned
May 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Interventional Pain Medicine Physician 208VP0014X 271526 NY
Pain Medicine (Anesthesiology) Physician 207LP2900X A134243 CA Primary

Addresses

Primary practice location

2101 Forest Ave Ste 220a
San Jose, CA 95128-1473

Mailing address

2101 Forest Ave Ste 220a
San Jose, CA 95128-1473
Phone (408) 295-8628

Other practice location 1

4235 Main St
Suite 3A
Flushing, NY 11355-3956
Phone (718) 886-7246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170323001113 NY Practitioner - Interventional Pain ManagementPractitioner - Anesthesiology 6800171356 Reassigns benefits to 2 organizations
I20200930000654 CA Practitioner - AnesthesiologyPractitioner - Pain Management 6800171356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
State University of New York Downstate Medical Center, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Justin Lo MD a Professional Medical CorporationGroup PAC ID 6800076878, 3 clinicians

Practice addresses (Care Compare)

2101 Forest Ave
Suite 220a
San Jose, CA 95128-1473
Phone (408) 295-8628

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
23.22 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
77.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A134243CAMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Justin Lo MD a Professional Medical Corporation Interventional Pain Medicine CurrentSince Oct 1, 2020 Accepting new patients
Specialty Anesthesia, PLLC CurrentSince Mar 20, 2017 Accepting new patients
Spine and Pain Consultant, PLLC Pain Medicine CurrentSince Mar 20, 2017 Accepting new patients
Plainview Hospital Interventional Pain Medicine Past Accepting new patients
County of Santa Clara Interventional Pain Medicine Past Accepting new patients
Long Island Jewish Medical Center Interventional Pain Medicine Past Accepting new patients
El Camino Health Medical Network, LLC Past Accepting new patients
El Camino Hospital Interventional Pain Medicine Past Accepting new patients

Locations

2101 Forest Ave
Ste 220A
San Jose, CA 95128
Phone (408) 295-8628

1 Hollow Ln
Ste 102
New Hyde Park, NY 11042
Phone (516) 502-1897

1534 Victory Blvd
Staten Island, NY 10314
Phone (718) 447-0055

1360 Hylan Blvd
Staten Island, NY 10305
Phone (718) 987-7300

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1242000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1194959775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 FOREST AVE STE 220A",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281473",
            "telephone_number": "408-295-8628",
            "fax_number": "408-295-8061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 FOREST AVE STE 220A",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281473",
            "telephone_number": "408-295-8628",
            "fax_number": "408-295-8061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4235 Main St",
            "address_2": "Suite 3A",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113553956",
            "country_code": "US",
            "telephone_number": "718-886-7246",
            "fax_number": "718-886-7247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "TANZINA",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-11",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NY",
            "license": "271526",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "CA",
            "license": "A134243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.