Active NPI
Saima Hassan Khan, MD
- Pediatrics Physician
- Lake Mary, FL
National Provider Identifier
1316985443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME105875
- Practice address
- 4300 W Lake Mary Blvd Ste 1010-369
Lake Mary, FL 32746-2060 - Phone
- (407) 377-6934
- NPI assigned
- Jun 2, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME105875 | FL | Primary |
Addresses
Primary practice location
4300 W Lake Mary Blvd Ste 1010-369
Lake Mary, FL 32746-2060
Mailing address
4300 W Lake Mary Blvd Ste 1010-369
Lake Mary, FL 32746-2060
Phone (407) 377-6934
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME105875 | FL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718668800000",
"number": "1316985443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4300 W LAKE MARY BLVD STE 1010-369",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327462060",
"telephone_number": "407-377-6934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 W LAKE MARY BLVD STE 1010-369",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327462060",
"telephone_number": "407-377-6934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "SAIMA",
"middle_name": "HASSAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-02",
"last_updated": "2024-06-18",
"certification_date": "2024-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME105875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Mary, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.