Tasneem Ahmad Khan, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

034005 Issued in CT

Practice address

1635 Central Avenue
Room 213 Southwest CT Mental Health System
Bridgeport, CT 06610

Phone

(203) 551-7660

Fax

(203) 551-7481

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

PsychiatryAlso: Neurology

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

State of ConnecticutGroup PAC ID 8022915677, 267 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• State of Connecticut

  • Psychiatric Hospital
  • Bridgeport, CT
  • NPI 1720013360
  Medicare reassignment Care Compare group NPD
• Trinity Health of New England Provider Network Organization Inc

  • Internal Medicine Physician
  • Hartford, CT
  • NPI 1003882812
  Medicare reassignment NPD
• Health and Mind LLC

  • Psychiatry Physician
  • Fairfield, CT
  • NPI 1891205761
  NPD Authorized official
• State of Connecticut

  • Skilled Nursing Facility
  • Rocky Hill, CT
  • NPI 1205951662
  NPD
• Trinity Health of New England Provider Network Organization Inc

  • Internal Medicine Physician
  • Waterville, ME
  • NPI 1134779531
  NPD
• Cycare LLC

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Bloomfield, CT
  • NPI 1336150002
  NPD (past)
• Cycare LLC

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Bloomfield, CT
  • NPI 1871866178
  NPD (past)
• Medoptions Behavioral Health Assoc, LLC

  • Nurse Practitioner
  • Old Saybrook, CT
  • NPI 1588604060

  Psychiatry

  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1679650378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 CENTRAL AVENUE",
            "address_2": "ROOM 213 SOUTHWEST CT MENTAL HEALTH SYSTEM",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06610",
            "telephone_number": "203-551-7660",
            "fax_number": "203-551-7481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 CENTRAL AVENUE",
            "address_2": "ROOM 213 SOUTHWEST CT MENTAL HEALTH SYSTEM",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "06610",
            "telephone_number": "203-551-7660",
            "fax_number": "203-551-7481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "TASNEEM",
        "middle_name": "AHMAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "034005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tkhan223904@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "CT Direct email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1635 Central Avenue",
            "address_2": "Room 213 Southwest CT Mental Health System",
            "city": "Bridgeport",
            "state": "CT",
            "country_code": "US",
            "postal_code": "06610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Abdul Rahim Khan, MD
• Jenifer Khan, MD
• Saima A Khan, DDS
• Shauna Khan, RDH
• Sundas Khan, DMD
• Yasmeen Khan
• Laura Khandjian, MD
• Prerna Khanna
• Veronika Kholodovych, MD
• Krishna Chaitanya Kilaru

• Psychiatry Physician in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; 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.

Verify at the official NPI Registry.