NPIMap

Individual provider Active NPI

Aftab A Khan, M.D.

  • Internal Medicine Physician
  • Davenport, FL
National Provider Identifier
1699851584
Registry record updated Apr 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME86482 Issued in FL
Practice address
2502 Sand Mine Rd
Davenport, FL 33897-3402
Phone
(863) 420-4077
Fax
(863) 420-4087
NPI assigned
Oct 31, 2006
Last updated
Apr 20, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME86482 FL Primary

Addresses

Primary practice location

2502 Sand Mine Rd
Davenport, FL 33897-3402

Mailing address

2502 Sand Mine Rd
Davenport, FL 33897-3402
Phone (863) 420-4077

Other identifiers 2

IdentifierTypeStateIssuer
268397100MedicaidFL
81359OtherFLBCBS OF FL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040408000858 FL Practitioner - Internal Medicine 9739172354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2500 Berry Blvd
Davenport, FL 33897-3800
Phone (863) 420-4077

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Management of Florida Inc CurrentSince Mar 18, 2022 Accepting new patients
David Mazer,M.D.,P.a. Past Accepting new patients
K Wade Foster MD PA Past Accepting new patients

Locations

2500 Berry Blvd
Davenport, FL 33897
Phone (863) 420-4077

2940 S US Highway 1
Ste C11
Fort Pierce, FL 34982
Phone (407) 423-5178

2155 SE Federal Hwy
Stuart, FL 34994
Phone (772) 223-9630

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: aftab.khan@wellmed.eclinicaldirectplus.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303257600000",
    "number": "1699851584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2502 SAND MINE RD",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338973402",
            "telephone_number": "863-420-4077",
            "fax_number": "863-420-4087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 SAND MINE RD",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338973402",
            "telephone_number": "863-420-4077",
            "fax_number": "863-420-4087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "AFTAB",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2011-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME86482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268397100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FL",
            "identifier": "81359",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

Verify at the official NPI Registry.