Active NPI
Bobby Khan, D.O.
- Family Medicine Physician
- Shortsville, NY
National Provider Identifier
1649565292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 267447
- Practice address
- 15 Canandaigua St
Shortsville, NY 14548-9763 - Phone
- (585) 289-3560
- NPI assigned
- Jun 12, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 267447 | NY | Primary |
Addresses
Primary practice location
15 Canandaigua St
Shortsville, NY 14548-9763
Mailing address
15 Canandaigua St
Shortsville, NY 14548-9763
Phone (585) 289-3560
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | bkhan121605@direct.urmc.rochester.edu | Direct | |
| Direct Messaging Address | bkhan121605@direct.urmc.rochester.edu | 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
15 Canandaigua St
Shortsville, NY 14548-9763
Phone (585) 289-3560
Hospital & facility affiliations
- Rochester Regional Health Home Care
- F F Thompson Hospital
- Strong Memorial Hospital
- Geneva General Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 267447 | NY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Frederick Ferris Thompson Hospital | Current | Accepting new patients | |
| The Frederick Ferris Thompson Hospital | Current | Accepting new patients |
Locations
350 Parrish St
Canandaigua, NY 14424
Phone (585) 396-6000
73 Buffalo St
Ste 100
Canandaigua, NY 14424
15 Canandaigua St
Shortsville, NY 14548
Phone (585) 289-3560
Interoperability endpoints
- bkhan121605@direct.urmc.rochester.edu
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Canandaigua, NY
- NPI 1194776351
-
- Community/Retail Pharmacy
- Victor, NY
- NPI 1831914274
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Rochester, NY
- NPI 1801819271
-
- General Acute Care Hospital
- Geneva, NY
- NPI 1952418352
-
- General Acute Care Hospital
- Canandaigua, NY
- NPI 1194776351
-
- General Acute Care Hospital
- Rochester, NY
- NPI 1346285657
-
- General Acute Care Hospital
- Rochester, NY
- NPI 1669126090
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687996800000",
"number": "1649565292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 CANANDAIGUA ST",
"city": "SHORTSVILLE",
"state": "NY",
"postal_code": "145489763",
"telephone_number": "585-289-3560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 CANANDAIGUA ST",
"city": "SHORTSVILLE",
"state": "NY",
"postal_code": "145489763",
"telephone_number": "585-289-3560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "BOBBY",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-12",
"last_updated": "2023-06-29",
"certification_date": "2020-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NY",
"license": "267447",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "bkhan121605@direct.urmc.rochester.edu",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "OTHER",
"address_1": "601 Elmwood Ave",
"city": "Rochester",
"state": "NY",
"country_code": "US",
"postal_code": "146420001",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "bkhan121605@direct.urmc.rochester.edu",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "OTHER",
"address_1": "601 Elmwood Ave",
"city": "Rochester",
"state": "NY",
"country_code": "US",
"postal_code": "146420001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Shortsville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.