Individual provider Active NPI

Fatima E Khan, M.D.

  • Allergy & Immunology Physician
  • Tampa, FL
National Provider Identifier
1891037446
Registry record updated Jan 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
ME142379 Issued in FL
Practice address
3645 Madaca LN
Tampa, FL 33618-2048
Phone
(813) 969-0116
Fax
(813) 969-3794
NPI assigned
Mar 21, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X ME142379 FL Primary

Addresses

Primary practice location

3645 Madaca LN
Tampa, FL 33618-2048

Mailing address

3645 Madaca LN
Tampa, FL 33618-2048
Phone (813) 969-0116

Other practice location 1

105 S Macdill Ave Ste 201
Tampa, FL 33609-3490
Phone (813) 969-0116

Other practice location 2

539 Medical Oaks Ave
Brandon, FL 33511-5961
Phone (813) 969-0116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200115001423 FL Practitioner - Allergy/Immunology 8022443365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aaia Tampa Bay, LLCGroup PAC ID 2264493014, 5 clinicians

Practice addresses (Care Compare)

3645 Madaca LN
Tampa, FL 33618-2048
Phone (813) 969-0116

Hospital & facility affiliations

  • St Josephs Hospital Hospital, Tampa, FL, CCN 100075

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aaia- Tampa Bay LLC Allergy & Immunology CurrentSince Dec 3, 2019 Accepting new patients

Locations

539 Medical Oaks Ave
Brandon, FL 33511
Phone (813) 655-9736

3645 Madaca Ln
Tampa, FL 33618
Phone (813) 450-3403

105 S Macdill Ave
Ste 201
Tampa, FL 33609
Phone (813) 874-1305

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.70677
  • Direct secure messaging: fatima.khan@aaia.directbygreenway.com

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1891037446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3645 MADACA LN",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182048",
            "telephone_number": "813-969-0116",
            "fax_number": "813-969-3794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3645 MADACA LN",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182048",
            "telephone_number": "813-969-0116",
            "fax_number": "813-969-3794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 S Macdill Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336093490",
            "country_code": "US",
            "telephone_number": "813-969-0116",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "539 Medical Oaks Ave",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335115961",
            "country_code": "US",
            "telephone_number": "813-969-0116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "FATIMA",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-21",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "FL",
            "license": "ME142379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.