Soorena Khojasteh, MD

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

MD439502 Issued in PA

Practice address

100 E Lancaster Ave Ste 261
Wynnewood, PA 19096-3450

Phone

(610) 658-1928

Fax

(484) 572-0482

NPI assigned

Aug 4, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

AnesthesiologyAlso: Pain Management

Education

Jefferson Medical College of Thomas Jefferson University, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bryn Mawr Hospital Hospital, Bryn Mawr, PA, CCN 390139
• Main Line Hospital Lankenau Hospital, Wynnewood, PA, CCN 390195
• Paoli Hospital Hospital, Paoli, PA, CCN 390153
• Riddle Memorial Hospital Hospital, Media, PA, CCN 390222
• Bryn Mawr Rehabilitation Hospital Inpatient rehabilitation facility, Malvern, PA, CCN 393025
• Good Shepherd Penn Partners Long-term care hospital, Philadelphia, PA, CCN 392050

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment Care Compare group NPD
• United Anesthesia Services PC

  • Anesthesiology Physician
  • Wynnewood, PA
  • NPI 1053366062
  Medicare reassignment
• Fka PHC, LLP

  • Surgery of the Hand (Surgery) Physician
  • Philadelphia, PA
  • NPI 1487680500
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Main Line Hospitals, Inc.

  • General Acute Care Hospital
  • Paoli, PA
  • NPI 1215042114
  Care Compare affiliation
• Main Line Hospitals, Inc.

  • General Acute Care Hospital
  • Wynnewood, PA
  • NPI 1245335629
  Care Compare affiliation
• Main Line Hospitals, Inc.

  • Rehabilitation Hospital
  • Malvern, PA
  • NPI 1396850368

  Inpatient rehabilitation facility

  Care Compare affiliation
• Main Line Hospitals, Inc.

  • General Acute Care Hospital
  • Bryn Mawr, PA
  • NPI 1508971441
  Care Compare affiliation
• Philadelphia Post Acute Partners, LLC

  • Long Term Care Hospital
  • Philadelphia, PA
  • NPI 1427232818

  Long-term care hospital

  Care Compare affiliation
• Riddle Memorial Hospital

  • General Acute Care Hospital
  • Media, PA
  • NPI 1407856099
  Care Compare affiliation

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540512000000",
    "number": "1508022179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE STE 261",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "610-658-1928",
            "fax_number": "484-572-0482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE STE 261",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "610-658-1928",
            "fax_number": "484-572-0482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOJASTEH",
        "first_name": "SOORENA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-04",
        "last_updated": "2018-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "PA",
            "license": "MD439502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Humza Khalid, MD
• Amid Khan, MD
• Tasleem Khan, PSY.D.
• Tamer Khashab, M.D.
• Adnan Khoja, MD
• Andrea Kirsch, CRNP
• Cullen Leeann Kisner, MD
• Michael Kitchens, MD
• Thomas Klee, PH.D.
• Jonah Klein

• Pain Medicine (Anesthesiology) Physician in Wynnewood, PA
• Providers in Wynnewood, PA by specialty
• Pain Medicine (Anesthesiology) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2018; 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.

Verify at the official NPI Registry.