Tarik Sharif Khan, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP013502 Issued in PA

Practice address

401 E City Ave
Suite 820
Bala Cynwyd, PA 19004-1122

Phone

(202) 669-7482

NPI assigned

May 29, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Group practices

Family Practice and Counseling Services NetworkGroup PAC ID 7012424740, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Family Practice & Counseling Services Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1043204811
  Medicare reassignment Care Compare group NPD
• Resources for Human Development, Inc.

  • Community/Behavioral Health Agency
  • Bryn Mawr, PA
  • NPI 1548395585
  Medicare reassignment NPD
• Family Practice & Counseling Services Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1689357782
  NPD
• Resources for Human Development, Inc.

  • Case Management Agency
  • Philadelphia, PA
  • NPI 1023143690
  NPD
• Resources for Human Development, Inc.

  • Federally Qualified Health Center (FQHC)
  • York, PA
  • NPI 1306127634
  NPD (past)

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

{
    "created_epoch": "1338249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1710247416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 KINGS OAK LN",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191154009",
            "telephone_number": "202-669-7482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E CITY AVE",
            "address_2": "SUITE 820",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041122",
            "telephone_number": "202-669-7482"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Wissahickon Ave Ste 118",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191444248",
            "country_code": "US",
            "telephone_number": "267-597-3600",
            "fax_number": "267-597-3622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "TARIK",
        "middle_name": "SHARIF",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-29",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "RN1023898",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP013502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102945836",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Kelly, AUD
• Joseph S Kenney III, D.O.
• Ketamine Wellness Infusions PA LLC
• Anika Nurin Khan, PHD
• Meher S Khan, MD
• Mohammed Shoaib Jameel Kidwai, MD
• Timothy Kim, OD
• Kinderbuch US P C
• Kinetic Home Care, LLC
• King RX, LLC

• Family Nurse Practitioner in Bala Cynwyd, PA
• Providers in Bala Cynwyd, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.