Individual provider Active NPI

Ismat Nasreen Khan, P.A.

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1790791325
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA02762 Issued in TX
Practice address
1631 E 2ND St Ste B
Austin, TX 78702-4491
Phone
(512) 804-3350
Fax
(512) 804-3672
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA02762 TX Primary

Addresses

Primary practice location

1631 E 2ND St Ste B
Austin, TX 78702-4491

Mailing address

PO Box 3548
Austin, TX 78764-3548
Phone (512) 445-7787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20070130000175 TX Practitioner - Physician Assistant 9638170913 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychiatry of Texas PLLC 418 clinicians

Practice addresses (Care Compare)

12180 N Mopac Expy
Suite B
Austin, TX 78758-2909
Phone (832) 869-4818

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA02762TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geode Health of Texas, PLLC CurrentSince Feb 16, 2026 Accepting new patients
Austin Travis County Mental Health and Mental Retardation Center Physician Assistant CurrentSince Jan 30, 2006 Accepting new patients
Austin Travis County Mental Health and Mental Retardation Center CurrentSince Jan 30, 2006 Accepting new patients
City of Austin Past Accepting new patients

Locations

1430 Collier St
Austin, TX 78704
Phone (512) 427-4357

1631 E 2nd St
Ste B
Austin, TX 78702
Phone (512) 804-3350

5353 Williams Dr
Ste 105
Georgetown, TX 78633
Phone (512) 546-7227

Organizations & group practices 8

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790791325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3548",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787643548",
            "telephone_number": "512-445-7787",
            "fax_number": "512-440-4059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 E 2ND ST STE B",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787024491",
            "telephone_number": "512-804-3350",
            "fax_number": "512-804-3672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "ISMAT",
        "middle_name": "NASREEN",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.