Individual provider Active NPI

Ayesha Fatima Khan, M.D.

  • Internal Medicine Physician
  • Clermont, FL
National Provider Identifier
1760844815
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME141267 Issued in FL
Practice address
1900 Don Wickham Dr
Clermont, FL 34711-1979
Phone
(352) 536-8830
Fax
(352) 536-8841
NPI assigned
Mar 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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 ME141267 FL Primary

Addresses

Primary practice location

1900 Don Wickham Dr
Clermont, FL 34711-1979

Mailing address

6101 Pine Ridge Rd
Naples, FL 34119-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20190827001405 FL Practitioner - Internal Medicine 1557699774 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians
HHA Associates LLCGroup PAC ID 2961839758, 125 clinicians

Practice addresses (Care Compare)

1900 Don Wickham Dr
Clermont, FL 34711-1979
Phone (352) 536-8840

5301 S Congress Ave
Atlantis, FL 33462-1149
Phone (561) 548-1953

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
70.52 of 100Reported as group
Quality
52.2
Improvement activities
40
Cost
80.57

Merit-based Incentive Payment System (MIPS)

Final score
79.91 of 100Reported as group
Quality
61.18
Promoting interoperability
100
Improvement activities
40
Cost
71.86

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Oct 1, 2023 Accepting new patients
HHA Associates LLC Hospitalist CurrentSince Nov 23, 2024 Accepting new patients
Cogent Healthcare of Jacksonville, LLC Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
Cogent Healthcare of Jacksonville, LLC Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
Orlando Health Medical Group Inc Internal Medicine CurrentSince Oct 1, 2023 Accepting new patients
Premier Inpatient Partners LLC Internal Medicine CurrentSince Aug 1, 2019 Accepting new patients

Locations

1920 Don Wickham Dr
Clermont, FL 34711
Phone (352) 243-5891

1900 Don Wickham Dr
Clermont, FL 34711
Phone (352) 536-8761

5301 S Congress Ave
Lantana, FL 33462
Phone (561) 548-3549

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

6101 Pine Ridge Rd
Naples, FL 34119
Phone (239) 348-4000

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

7201 N University Dr
Tamarac, FL 33321
Phone (954) 721-2200

2201 45th St
West Palm Beach, FL 33407
Phone (561) 842-6141

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: akhan2542047@direct.trinity-health.org
  • FHIR API: https://api.platform.athenahealth.com/14267/brand/6/csg/1/fhir/r4

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1459036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1760844815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 PINE RIDGE RD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341193900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 DON WICKHAM DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111979",
            "telephone_number": "352-536-8830",
            "fax_number": "352-536-8841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "AYESHA",
        "middle_name": "FATIMA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-27",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME141267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.