Individual provider Active NPI

Tasfia Anjum Khan

  • Pediatrics Physician
  • Rochester, NY
National Provider Identifier
1679250633
Registry record updated Aug 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
P25-01366 Issued in NJ
Practice address
425 Beach Ave
Rochester, NY 14612-2011
Phone
(917) 686-6162
NPI assigned
Jun 30, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X P25-01366 NJ Primary
Internal Medicine Physician 207R00000X P122560 NY

Addresses

Primary practice location

425 Beach Ave
Rochester, NY 14612-2011

Mailing address

10469 NW 289TH Ave
North Plains, OR 97133-2044
Phone (469) 386-8270

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
I20231010002603 NY Practitioner - Internal Medicine 1052766177 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nys Medical Associate PLLC Internal Medicine CurrentSince Aug 15, 2023 Accepting new patients

Locations

300 Community Dr
Plandome, NY 11030

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.

NPI Registry JSON

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

{
    "created_epoch": "1688083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785542400000",
    "number": "1679250633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10469 NW 289TH AVE",
            "city": "NORTH PLAINS",
            "state": "OR",
            "postal_code": "971332044",
            "telephone_number": "469-386-8270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 BEACH AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146122011",
            "telephone_number": "917-686-6162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "TASFIA ANJUM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-30",
        "last_updated": "2026-08-01",
        "certification_date": "2026-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "P25-01366",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "P122560",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.