Azima Tariq Khan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME86844 Issued in FL

Practice address

145 Miami Ave E
Venice, FL 34285-2407

Phone

(941) 480-0088

Fax

(941) 480-0006

NPI assigned

Sep 6, 2006

Last updated

Aug 9, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: azima.khan@fpg.directbygreenway.com

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.

• SMH Physician Services Inc

  dba First Physicians Group

  • Internal Medicine Physician
  • Sarasota, FL
  • NPI 1346295292

  Pediatrics

  Medicare reassignment NPD
• SMH Physician Services Inc

  dba First Physicians Group

  • Gynecology Physician
  • Sarasota, FL
  • NPI 1275525826
  NPD (past)
• Alliance Community Healthcare, Inc.

  • Federally Qualified Health Center (FQHC)
  • Jersey City, NJ
  • NPI 1285662684
  NPD (past)

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1912000175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863407",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328863407",
            "telephone_number": "941-917-2600",
            "fax_number": "941-917-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 MIAMI AVE E",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342852407",
            "telephone_number": "941-480-0088",
            "fax_number": "941-480-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "AZIMA",
        "middle_name": "TARIQ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME86844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1235351412",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1912000175",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002939500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zoe Kennedy
• Marcia Keperling, SLP
• Christopher Kerio, DC
• Kerry Kajdasz Lac, LLC
• Elena U Kesterson, PA
• Jaffer J Khan, MD
• Tariq J Khan, MD
• Nilofer A. Khatri, D.M.D.
• Clinton T Khoury, PT
• Ki Hassler, DO, LLC

• Pediatrics Physician in Venice, FL
• Providers in Venice, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.