Tazleem Shazad Khan, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

276217 Issued in NY

Practice address

4250 Hempstead Tpke Ste 17
Bethpage, NY 11714-5707

Phone

(516) 735-5522

Fax

(516) 644-5385

NPI assigned

Mar 25, 2011

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

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

NephrologyAlso: Internal Medicine

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Long Island Kidney Associates, PCGroup PAC ID 0345426284, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• DaVita Long Island Renal Care Dialysis facility, Amityville, NY, CCN 332670
• DaVita East Islip Dialysis Dialysis facility, East Islip, NY, CCN 332752
• Davita Massapequa Dialysis Dialysis facility, Massapequa, NY, CCN 332846
• Good Samaritan Hospital Medical Center Hospital, West Islip, NY, CCN 330286
• Plainview Hospital Hospital, Plainview, NY, CCN 330331
• Chsli St Joseph Hospital Hospital, Bethpage, NY, CCN 330332

Merit-based Incentive Payment System (MIPS)

Final score

19.51 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

65.03

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Long Island Kidney Associates, PC

  • Specialist
  • Bethpage, NY
  • NPI 1295036531
  Medicare reassignment Care Compare group NPD
• SPS Medical PC

  • Internal Medicine Physician
  • Bethpage, NY
  • NPI 1871634253
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• True North Dialysis Center LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Massapequa, NY
  • NPI 1124753603

  Dialysis facility

  Care Compare affiliation Name & address match
• Good Samaritan Hospital Medical Center

  • General Acute Care Hospital
  • West Islip, NY
  • NPI 1902865355
  Care Compare affiliation
• Plainview Hospital

  • General Acute Care Hospital
  • Plainview, NY
  • NPI 1083621130
  Care Compare affiliation
• Wsnchs North, Inc.

  • General Acute Care Hospital
  • Bethpage, NY
  • NPI 1013998426
  Care Compare affiliation

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

{
    "created_epoch": "1301011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1821397100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414028",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 HEMPSTEAD TPKE STE 17",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117145707",
            "telephone_number": "516-735-5522",
            "fax_number": "516-644-5385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "TAZLEEM",
        "middle_name": "SHAZAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-25",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "276217",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "276217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Kessler, D.O.
• Brendan J. Keys, NP
• Abdus S Khan, MD
• Faiza Khan, MD
• Muhammad Imran Khan
• Umaima Niaz Khan
• Inrava Khasnabish, O.D.
• Tarulata Khulpateea, M.D.
• Amy L Kidney, CNM
• Erin Kiley

• Nephrology Physician in Bethpage, NY
• Providers in Bethpage, NY by specialty
• Nephrology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.