Active NPI
Ismat Nasreen Khan, P.A.
- Physician Assistant
- Austin, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA02762
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| PA02762 | TX | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Geode Health of Texas, PLLC | Current | Accepting new patients | |
| Austin Travis County Mental Health and Mental Retardation Center | Physician Assistant | Current | Accepting new patients |
| Austin Travis County Mental Health and Mental Retardation Center | Current | 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.
-
- Psychiatry Physician
- Austin, TX
- NPI 1750337259
Physician Assistant, TX
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Austin, TX
- NPI 1053632505
-
- Psychiatry Physician
- Allen, TX
- NPI 1851037162
-
- Emergency Medical Services (Emergency Medicine) Physician
- Austin, TX
- NPI 1083245070
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.