Active NPI
Tushar Khanna, MD
- Gastroenterology Physician
- Southfield, MI
National Provider Identifier
1669931432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- 4301514012
- Practice address
- 22250 Providence Dr Ste 301a
Southfield, MI 48075-6211 - Phone
- (248) 849-3254
- NPI assigned
- Mar 19, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 4301514012 | MI | |
| Gastroenterology Physician | 207RG0100X | 4301514012 | MI | Primary |
| Hospitalist Physician | 208M00000X | MD481430 | PA | |
| Internal Medicine Physician | 207R00000X | MD481430 | PA |
Addresses
Primary practice location
22250 Providence Dr Ste 301a
Southfield, MI 48075-6211
Mailing address
3400 Spruce St
Philadelphia, PA 19104-4238
Other practice location 1
3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 796-4640
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200715000427 | MI | Order and Referring Only - Internal Medicine | 5890118442 |
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 84.91 of 100
- Quality
- 73.58
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.13
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD481430 | PA | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Presbyterian Medical Center of the University of Pennsylvania Health S | Past | Accepting new patients |
Organizations & group practices 1
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
- Philadelphia, PA
- NPI 1245207521
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788307200000",
"number": "1669931432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 SPRUCE ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22250 PROVIDENCE DR STE 301A",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480756211",
"telephone_number": "248-849-3254"
}
],
"practiceLocations": [
{
"address_1": "3400 Spruce St",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191044238",
"country_code": "US",
"telephone_number": "215-796-4640",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KHANNA",
"first_name": "TUSHAR",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-03-19",
"last_updated": "2026-09-02",
"certification_date": "2026-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": "MI",
"license": "4301514012",
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "MI",
"license": "4301514012",
"primary": true
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "PA",
"license": "MD481430",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MD481430",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; 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.