Individual provider Active NPI

Nida Mumtaz Khan, M.D.

  • Ophthalmology Physician
  • Allentown, PA
National Provider Identifier
1255745667
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD465213 Issued in PA
Practice address
401 N 17TH St Ste 103
Allentown, PA 18104
Phone
(610) 969-3070
Fax
(610) 969-3073
NPI assigned
Jun 13, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD465213 PA Primary

Addresses

Primary practice location

401 N 17TH St Ste 103
Allentown, PA 18104

Mailing address

PO Box 783311
Philadelphia, PA 19178-3311
Phone (484) 884-4500

Other practice location 1

219 N Broad St
3rd Floor
Philadelphia, PA 19107-1519
Phone (215) 762-3937

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180910001465 PA Practitioner - Ophthalmology 3870843055 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

401 N 17TH St
103 LVPG Ophthalmology
Allentown, PA 18104-5049
Phone (610) 969-3070

Hospital & facility affiliations

  • Lehigh Valley Hospital Hospital, Allentown, PA, CCN 390133

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery141

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD465213PAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lehigh Valley Physician Group CurrentSince Sep 10, 2018 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Sep 10, 2018 Accepting new patients
Pulmonary Associates PC Past Accepting new patients
Lehigh Valley Physician Group Ophthalmology PastSince Jan 22, 2023 Accepting new patients

Locations

401 N 17th St
Ste 103
Allentown, PA 18104
Phone (610) 821-9454

2100 Mack Blvd
Fl 4
Allentown, PA 18103

1431 Nursery St
Ste 200
Fogelsville, PA 18051
Phone (484) 273-4390

5649 Wynnewood Dr
Ste 104
Laurys Station, PA 18059
Phone (610) 262-6641

Interoperability endpoints

  • Direct secure messaging: nkhan305899@direct2.lvhn.org

Organizations & group practices 6

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.

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": "1402617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1255745667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 783311",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191783311",
            "telephone_number": "484-884-4500",
            "fax_number": "484-884-0699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N 17TH ST STE 103",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "18104",
            "telephone_number": "610-969-3070",
            "fax_number": "610-969-3073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "219 N Broad St",
            "address_2": "3rd Floor",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191071519",
            "country_code": "US",
            "telephone_number": "215-762-3937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "NIDA",
        "middle_name": "MUMTAZ",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-13",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD465213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.