Pervez Ali Khan, MD is a medicare enrolled "General Practice" physician in Lackawanna, New York. His current practice location is
2600 Southpark Avenue, Lackawanna, New York. You can reach out to his office (for appointments etc.) via phone at
(716) 822-2028.
Pervez Ali Khan is licensed to practice in New York (license number 125843) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1780857854.
Physician's Profile
| Full Name | Pervez Ali Khan |
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| Gender | Male |
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| Speciality | General Practice |
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| Location | 2600 Southpark Avenue, Lackawanna, New York |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1780857854
- Provider Enumeration Date: 04/09/2008
- Last Update Date: 04/05/2017
Medicare PECOS Information:
- PECOS PAC ID: 9133298862
- Enrollment ID: I20080520000799
Medical Identifiers
Medical identifiers for Pervez Ali Khan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1780857854 | NPI | - | NPPES |
| 2197231 | Other | NY | COVENTRY |
| 4538333 | Other | NY | AETNA |
| RB8099 | Other | NY | MEDICARE RAILROAD |
| 02961200 | Medicaid | NY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208D00000X | General Practice | 125843 (New York) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Pervez Ali Khan allows following entities to bill medicare on his behalf.
| Entity Name | Wny Medical Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1154421246
PECOS PAC ID: 9335191733
Enrollment ID: O20050214000821 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Pervez Ali Khan is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Pervez Ali Khan, MD
2600 Southpark Avenue,
Lackawanna, NY 14218-1504
Ph: (716) 822-2028 | Pervez Ali Khan, MD
2600 Southpark Avenue,
Lackawanna, NY 14218-1504
Ph: (716) 822-2028 |
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