Individual provider Active NPI

Asif Khan, MD

  • Internal Medicine Physician
  • Lakewood, WA
National Provider Identifier
1821044520
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00044522 Issued in WA
Practice address
PO Box 39680
Lakewood, WA 98496-3680
Phone
(253) 200-0300
Fax
(253) 302-8493
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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 MD00044522 WA Primary

Addresses

Primary practice location

PO Box 39680
Lakewood, WA 98496-3680

Mailing address

PO Box 39680
Lakewood, WA 98496-3680
Phone (253) 200-0300

Other identifiers 7

IdentifierTypeStateIssuer
98390A019OtherWATRICARE PROVIDER NUMBER
9865KAOtherWAREGENCE RIDER NUMBER
7386691OtherWAAETNA PROVIDER NUMBER
0251533OtherWAL&I PROVIDER #
911203494BZOtherWAKPS PROVIDER NUMBER
0195278OtherWAL & I PROVIDER NUMBER
8421091MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20050427000436 WA Practitioner - Internal Medicine 1052350311 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00044522WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rainier Internal Medicine LLC Internal Medicine CurrentSince Aug 14, 1974 Accepting new patients
Rainier Internal Medicine LLC Current Accepting new patients
Good Samaritan Community Healthcare Internal Medicine Past Accepting new patients
John Daniel M.D, PS, Inc. PastSince Jan 1, 2004 Accepting new patients
Multicare Health System Past Accepting new patients

Locations

3800 3rd St SE
Puyallup, WA 98374
Phone (253) 200-0415

102 23rd Ave SE
Ste B
Puyallup, WA 98372
Phone (253) 200-0300

9720 South Tacoma Way
Tacoma, WA 98499
Phone (253) 304-7753

3727 South Tacoma Way
Tacoma, WA 98409
Phone (253) 300-7474

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1821044520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39680",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984963680",
            "telephone_number": "253-200-0300",
            "fax_number": "253-302-8493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 39680",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984963680",
            "telephone_number": "253-200-0300",
            "fax_number": "253-302-8493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "ASIF",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00044522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE PROVIDER NUMBER",
            "identifier": "98390A019",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE RIDER NUMBER",
            "identifier": "9865KA",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "7386691",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I PROVIDER #",
            "identifier": "0251533",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KPS PROVIDER NUMBER",
            "identifier": "911203494BZ",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I PROVIDER NUMBER",
            "identifier": "0195278",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8421091",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

Verify at the official NPI Registry.