NPIMap

Individual provider Active NPI

Kashan R Khan, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Kissimmee, FL
National Provider Identifier
1497959886
Registry record updated May 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
ME-100789 Issued in FL
Practice address
327 West Cypress Street
PM Pediatrics, P.a.
Kissimmee, FL 34741
Phone
(407) 483-0672
Fax
(407) 348-5882
NPI assigned
Jun 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X ME-100789 FL Primary

Addresses

Primary practice location

327 West Cypress Street
PM Pediatrics, P.a.
Kissimmee, FL 34741

Mailing address

31810 U.S. Highway 27
P M Pediatrics, P.a.
Haines City, FL 33844
Phone (863) 419-1428

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090211000822 FL Practitioner - Family PracticePractitioner - Geriatric Medicine 3173688835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2400 N Blvd W
Davenport, FL 33837-8980
Phone (863) 422-1890

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME-100789FLMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chamber of Medicine P.a. CurrentSince Nov 18, 2009 Accepting new patients

Locations

2400 North Blvd W
Davenport, FL 33837
Phone (407) 572-8900

2231 North Blvd W
Davenport, FL 33837
Phone (863) 419-1428

327 W Cypress St
Kissimmee, FL 34741
Phone (407) 483-0672

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CBJJBA
  • FHIR API: https://fhir4.healow.com/fhir/r4/CBJJBA/Endpoint/CBJJBA

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.

Hospital & facility affiliations 7

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": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1497959886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31810 U.S. HIGHWAY 27",
            "address_2": "P M PEDIATRICS, P.A.",
            "city": "HAINES CITY",
            "state": "FL",
            "postal_code": "33844",
            "telephone_number": "863-419-1428",
            "fax_number": "863-422-1893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 WEST CYPRESS STREET",
            "address_2": "PM PEDIATRICS, P.A.",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "34741",
            "telephone_number": "407-483-0672",
            "fax_number": "407-348-5882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "KASHAN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME-100789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

Verify at the official NPI Registry.