Individual provider Active NPI

Nazim A. Khan, PA-C

  • Physician Assistant
  • Buffalo, NY
National Provider Identifier
1275976045
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
022068 Issued in NY
Practice address
135 Grant St
Buffalo, NY 14213-1604
Phone
(716) 881-4300
Fax
(716) 881-5300
NPI assigned
Apr 11, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 022068 NY Primary

Addresses

Primary practice location

135 Grant St
Buffalo, NY 14213-1604

Mailing address

4979 Harlem Rd
Amherst, NY 14226-2547
Phone (716) 923-4380

Other practice location 1

6450 West College Drive
Palos Heights, IL 60463
Phone (708) 389-1500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180620001399 NY Practitioner - Physician Assistant 1052545225 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wny Medical PCGroup PAC ID 9335191733, 44 clinicians

Practice addresses (Care Compare)

135 Grant St
Buffalo, NY 14213-1604
Phone (716) 881-4300

147 Reist St
Williamsville, NY 14221-5321
Phone (716) 633-5400

4979 Harlem Rd
Amherst, NY 14226-2547
Phone (716) 923-4380

909 Pine Ave
Niagara Falls, NY 14301-1807
Phone (716) 453-4027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Western New York Immediate Medical Care LLC CurrentSince Oct 1, 2018 Accepting new patients
Western New York MRI LLP Past Accepting new patients

Locations

2099 Niagara Falls Blvd
Amherst, NY 14228
Phone (716) 204-2273

Interoperability endpoints

  • Direct secure messaging: nkhan@wnymedical.medentdirect.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1275976045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4979 HARLEM RD",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142262547",
            "telephone_number": "716-923-4380",
            "fax_number": "716-923-4384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 GRANT ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142131604",
            "telephone_number": "716-881-4300",
            "fax_number": "716-881-5300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6450 West College Drive",
            "address_purpose": "LOCATION",
            "city": "Palos Heights",
            "state": "IL",
            "postal_code": "60463",
            "country_code": "US",
            "telephone_number": "708-389-1500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "NAZIM",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-11",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "022068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.