Individual provider Active NPI

Saira Khan

  • Pediatrics Physician
  • Staten Island, NY
National Provider Identifier
1578958088
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA10276600 Issued in NJ
Practice address
2066 Richmond Ave
Staten Island, NY 10314
Phone
(718) 982-9001
Fax
(718) 982-9008
NPI assigned
Apr 1, 2015
Last updated
Mar 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA10276600 NJ Primary
Pediatrics Physician 208000000X 285624-1 NY

Addresses

Primary practice location

2066 Richmond Ave
Staten Island, NY 10314

Mailing address

2066 Richmond Ave
Staten Island, NY 10314-3960
Phone (718) 982-9001

Other practice location 1

610 Cranbury Rd
East Brunswick, NJ 08816-4030
Phone (732) 257-4330

Other names 1

  • Saira Khan Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20230328000042 NJ Practitioner - Pediatric Medicine 9638543945 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
285624-1NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maimonides Medical Center Current Accepting new patients
Advocare, LLC Pediatrics CurrentSince May 1, 2023 Accepting new patients
Advocare , LLC CurrentSince May 1, 2023 Accepting new patients
Advocare, LLC Pediatrics Past Accepting new patients
Advocare, LLC Pediatrics PastSince Feb 26, 2023 Accepting new patients

Locations

169 Mine Brook Rd
#P
Bernardsville, NJ 07924
Phone (908) 766-0034

33 Brunswick Woods Dr
East Brunswick, NJ 08816
Phone (732) 257-4330

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

401 Route 73 N
Ste 320
Marlton, NJ 08053
Phone (609) 471-1033

25 Lindsley Dr
Ste 205
Morristown, NJ 07960
Phone (973) 993-8777

Interoperability endpoints

  • Direct secure messaging: saira.khan@advocaredoctors.eclinicaldirectplus.com
  • Direct secure messaging: sairakhan@mai.allscriptsdirect.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1578958088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2066 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143960",
            "telephone_number": "718-982-9001",
            "fax_number": "718-982-9008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2066 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10314",
            "telephone_number": "718-982-9001",
            "fax_number": "718-982-9008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "610 Cranbury Rd",
            "address_purpose": "LOCATION",
            "city": "East Brunswick",
            "state": "NJ",
            "postal_code": "088164030",
            "country_code": "US",
            "telephone_number": "732-257-4330",
            "fax_number": "732-257-1177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SAIRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-01",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA10276600",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "285624-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAIRA",
            "last_name": "KHAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.