Active NPI
Asjad U Khan, MD
- Pediatric Endocrinology Physician
- Port Charlotte, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Endocrinology Physician
- License
- ME99779
- Practice address
- 22655 Bayshore Rd Ste 110
Port Charlotte, FL 33980-2005 - Phone
- (941) 235-4900
- Fax
- (941) 235-4901
- NPI assigned
- Aug 13, 2006
- Last updated
- Jun 27, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME99779 | FL | |
| Pediatric Endocrinology Physician | 2080P0205X | 222881 | NY | |
| Pediatric Endocrinology Physician | 2080P0205X | ME99779 | FL | Primary |
Addresses
Primary practice location
22655 Bayshore Rd Ste 110
Port Charlotte, FL 33980-2005
Mailing address
PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-9890
Other practice location 1
15901 Bass Rd
Suite 102
Fort Myers, FL 33908-3838
Phone (239) 343-9890
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02640926 | Medicaid | NY | |
| 279556600 | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | akhan4771@Direct.leememorial.org | Lee Memorial Health System |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Endocrinology
- Education
- Icahn School of Medicine at Mount Sinai, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900
15901 Bass Rd
Fort Myers, FL 33908-3838
3361 Pine Ridge Rd
Suite 201
Naples, FL 34109-3938
Phone (239) 343-9722
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 222881 | NY | MD | Pediatric Endocrinology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lee Memorial Health System | Current | Accepting new patients | |
| Lee Health System Inc | Current | Accepting new patients | |
| Lee Health System Inc | Pediatrics | Current | Accepting new patients |
| Lee Memorial Health System | Pediatrics | Current | Accepting new patients |
Locations
1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900
15901 Bass Rd
Ste 102
Fort Myers, FL 33908
Phone (239) 343-9890
2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000
8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030
930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520
3361 Pine Ridge Rd
Ste 201
Naples, FL 34109
Phone (239) 254-4270
22655 Bayshore Rd
Ste 110
Punta Gorda, FL 33980
Phone (941) 235-4900
Interoperability endpoints
- akhan4771@direct.leememorial.org
Organizations & group practices 4
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.
-
dba Lee Health Specialty Pharmacy
- Community/Retail Pharmacy
- Bonita Springs, FL
- NPI 1699510925
-
dba LCH-Golisano Peds PC Bayshore
- Federally Qualified Health Center (FQHC)
- Port Charlotte, FL
- NPI 1255171765
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Lee Memorial Hospital
- General Acute Care Hospital
- Fort Myers, FL
- NPI 1427806025
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719446400000",
"number": "1265444715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2147",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339022147",
"telephone_number": "239-343-9890",
"fax_number": "239-343-4191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22655 BAYSHORE RD STE 110",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339802005",
"telephone_number": "941-235-4900",
"fax_number": "941-235-4901"
}
],
"practiceLocations": [
{
"address_1": "15901 Bass Rd",
"address_2": "Suite 102",
"address_purpose": "LOCATION",
"city": "Fort Myers",
"state": "FL",
"postal_code": "339083838",
"country_code": "US",
"telephone_number": "239-343-9890",
"fax_number": "239-343-9898",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KHAN",
"first_name": "ASJAD",
"middle_name": "U",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-13",
"last_updated": "2024-06-27",
"certification_date": "2024-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME99779",
"primary": false
},
{
"code": "2080P0205X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Endocrinology",
"state": "NY",
"license": "222881",
"primary": false
},
{
"code": "2080P0205X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Endocrinology",
"state": "FL",
"license": "ME99779",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02640926",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "279556600",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "akhan4771@Direct.leememorial.org",
"affiliation": "Y",
"affiliationName": "Lee Memorial Health System",
"address_1": "2776 Cleveland Ave",
"city": "Fort Myers",
"state": "FL",
"country_code": "US",
"postal_code": "339015864",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Port Charlotte, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.