Individual provider Active NPI

Ihsan U Khan, MD

  • Pulmonary Disease Physician
  • Binghamton, NY
National Provider Identifier
1578876991
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
254985 Issued in NY
Practice address
161 Riverside Drive
Suite 305
Binghamton, NY 13905
Phone
(607) 798-5442
Fax
(607) 798-5876
NPI assigned
Jul 15, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 254985 NY
Internal Medicine Physician 207R00000X 254985-1 NY
General Practice Physician 208D00000X 254985 NY
Hospitalist Physician 208M00000X 254985-1 NY
Pulmonary Disease Physician 207RP1001X 254985 NY Primary

Addresses

Primary practice location

161 Riverside Drive
Suite 305
Binghamton, NY 13905

Mailing address

161 Riverside Drive
Suite 305
Binghamton, NY 13905
Phone (607) 798-5442

Other identifiers 1

IdentifierTypeStateIssuer
03361644MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ihsan.khan@direct.lourdes.com Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110707000329 NY Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 5991983355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

169 Riveride Dr
Binghamton, NY 13905-4246

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
254985NYMDPulmonary Disease Physician
254985-1NYMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Tier Pathology Associates, PC Current Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. CurrentSince Jul 11, 2011 Accepting new patients
Our Lady of Lourdes Memorial Hospital Inc. CurrentSince Jul 11, 2011 Accepting new patients
Our Lady of Lourdes Memorial Hospital, Inc. Internal Medicine Current Accepting new patients

Locations

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

161 Riverside Dr
Ste 305
Binghamton, NY 13905
Phone (607) 729-1521

169 Riverside Dr
Ofc
Binghamton, NY 13905
Phone (607) 722-2769

169 Riverside Dr
Ste 206
Binghamton, NY 13905
Phone (607) 798-6701

39 E Main St
Hancock, NY 13783
Phone (607) 637-5700

Interoperability endpoints

  • Direct secure messaging: ikhan196876@direct-guthrie.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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1578876991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 RIVERSIDE DRIVE",
            "address_2": "SUITE 305",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "13905",
            "telephone_number": "607-798-5442",
            "fax_number": "607-798-5876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 RIVERSIDE DRIVE",
            "address_2": "SUITE 305",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "13905",
            "telephone_number": "607-798-5442",
            "fax_number": "607-798-5876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "IHSAN",
        "middle_name": "U",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-15",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "254985",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "254985-1",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "254985",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "254985-1",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "254985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03361644",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ihsan.khan@direct.lourdes.com",
            "affiliation": "N",
            "endpointDescription": "Lourdes Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "169 Riverside Dr",
            "city": "Binghamton",
            "state": "NY",
            "country_code": "US",
            "postal_code": "139054246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

Verify at the official NPI Registry.