Active NPI
Tara Khan, D.O.
- Emergency Medicine Physician
- Tampa, FL
National Provider Identifier
1255533881
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- OS10823
- Practice address
- 3100 E Fletcher Avenue
Tampa, FL 33613-4613 - Phone
- (813) 971-6000
- Fax
- (813) 972-5753
- NPI assigned
- Jun 5, 2007
- Last updated
- Sep 10, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 238186-1 | NY | |
| Emergency Medicine Physician | 207P00000X | OS10823 | FL | Primary |
Addresses
Primary practice location
3100 E Fletcher Avenue
Tampa, FL 33613-4613
Mailing address
12479 Telecom Drive
Tampa, FL 33637-0913
Phone (813) 972-4199
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001717300 | Medicaid | FL | |
| 02957922 | Medicaid | NY |
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 238186-1 | NY | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Palms of Pasadena Emergency Physicians LLC | Emergency Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Emergency Medicine Physician
- South Pasadena, FL
- NPI 1164436341
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347235200000",
"number": "1255533881",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12479 TELECOM DRIVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336370913",
"telephone_number": "813-972-4199",
"fax_number": "813-972-5753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 E FLETCHER AVENUE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336134613",
"telephone_number": "813-971-6000",
"fax_number": "813-972-5753"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "TARA",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-05",
"last_updated": "2012-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NY",
"license": "238186-1",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "FL",
"license": "OS10823",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001717300",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02957922",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.