NPIMap

Individual provider Active NPI

Hasibul Hassan Khan, MD

  • Family Medicine Physician
  • Inverness, FL
National Provider Identifier
1831251446
Registry record updated Dec 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME100419 Issued in FL
Practice address
213 S Pine Ave
Inverness, FL 34452-4830
Phone
(352) 560-3000
Fax
(352) 419-6513
NPI assigned
Dec 14, 2006
Last updated
Dec 29, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME100419 FL Primary

Addresses

Primary practice location

213 S Pine Ave
Inverness, FL 34452-4830

Mailing address

3404 N Lecanto Hwy Suite C
Beverly Hills, FL 34465-4830
Phone (352) 746-0600

Other identifiers 1

IdentifierTypeStateIssuer
001124800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081014000652 FL Practitioner - Family Practice 2365522968 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nature Coast Geriatric Services LLCGroup PAC ID 0244541282, 13 clinicians

Practice addresses (Care Compare)

213 S Pine Ave
Inverness, FL 34452-4830
Phone (352) 560-3000

3400 N Lecanto Hwy
C
Beverly Hills, FL 34465-3548

3404 N Lecanto Hwy
Beverly Hills, FL 34465-3569
Phone (352) 746-2227

3737 N Lecanto Hwy
Beverly Hills, FL 34465-3504
Phone (352) 746-1515

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME100419FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tampa General Hospital Current Accepting new patients
West Florida Medical Associates P a Family Medicine CurrentSince Apr 1, 2008 Accepting new patients
Nature Coast Geriatric Services LLC Family Medicine CurrentSince Mar 23, 2015 Accepting new patients
West Florida Medical Associates, PA Family Medicine CurrentSince Apr 1, 2008 Accepting new patients

Locations

3400 N Lecanto Hwy
#A
Beverly Hills, FL 34465
Phone (352) 746-2227

3404 N Lecanto Hwy
Ste A
Beverly Hills, FL 34465
Phone (352) 513-4867

3404 N Lecanto Hwy
Ste C
Beverly Hills, FL 34465
Phone (352) 746-1558

3737 N Lecanto Hwy
Beverly Hills, FL 34465
Phone (352) 746-1515

4363 S Suncoast Blvd
Homosassa Springs, FL 34446
Phone (352) 503-2011

213 S Pine Ave
Inverness, FL 34452
Phone (352) 560-3000

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: hkhan296912@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Comprehensive Primary CareInverness, FL, CCN 103834 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
W-2 Managing Employee		 Jan 1, 2012
Apr 2, 2008
Comprehensive Primary CareHomosassa, FL, CCN 683814 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
W-2 Managing Employee (100%)		 Mar 2, 2013
Mar 2, 2013

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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.

Hospital & facility affiliations 12

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": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419811200000",
    "number": "1831251446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3404 N LECANTO HWY SUITE C",
            "city": "BEVERLY HILLS",
            "state": "FL",
            "postal_code": "344654830",
            "telephone_number": "352-746-0600",
            "fax_number": "352-746-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 S PINE AVE",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344524830",
            "telephone_number": "352-560-3000",
            "fax_number": "352-419-6513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "HASIBUL",
        "middle_name": "HASSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2014-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME100419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001124800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Inverness, FL

Sources for this page

Verify at the official NPI Registry.