Organization Active NPI

Sadia Khan Inc., a Professional Corporation

  • Surgery Physician
  • Newport Beach, CA
National Provider Identifier
1639553829
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SADIA KHAN INC., A PROFESSIONAL CORPORATION
Practice address
1 Hoag Dr
Newport Beach, CA 92663-4162
Phone
(949) 764-8281
Fax
(949) 764-8236
NPI assigned
Jul 17, 2015
Last updated
Aug 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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

Authorized official

Name
Dr. Sadia Khan, D.O.NPI 1205134665
Title
President
Phone
(281) 948-2042

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Primary

Addresses

Primary practice location

1 Hoag Dr
Newport Beach, CA 92663-4162

Mailing address

120 Tustin Ave # C1073
Newport Beach, CA 92663-4729
Phone (949) 857-1473

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151014001333 CA Part B Supplier - Clinic/Group Practice 9739498767 Receives reassigned benefits from 1 practitioner
Practice locations: Irvine, CA; Newport Beach, CA

National Provider Directory

National Provider Directory

Locations

120 Tustin Ave
#C1073
Newport Beach, CA 92663

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1437091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439769600000",
    "number": "1639553829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 TUSTIN AVE # C1073",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634729",
            "telephone_number": "949-857-1473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOAG DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926634162",
            "telephone_number": "949-764-8281",
            "fax_number": "949-764-8236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SADIA KHAN INC., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-17",
        "last_updated": "2015-08-17",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "SADIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-948-2042",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.