NPIMap

Individual provider Active NPI

Kousai O Ali Khan, PA

  • Physician Assistant
  • Gloversville, NY
National Provider Identifier
1023528312
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
021448 Issued in NY
Practice address
99 E State St
Gloversville, NY 12078-1203
Phone
(518) 725-8621
NPI assigned
Oct 2, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 021448 NY Primary

Addresses

Primary practice location

99 E State St
Gloversville, NY 12078-1203

Mailing address

23 Monroe St
Gloversville, NY 12078-4119
Phone (518) 844-4941

Other practice location 1

1101 Nott St
Schenectady, NY 12308-2425
Phone (518) 243-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20171014000095 NY Practitioner - Physician Assistant 0648545814 Reassigns benefits to 11 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
State University of Ny Upstate Medical University, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gloversville Emergency Medicine Services PCGroup PAC ID 7517107881, 15 clinicians

Practice addresses (Care Compare)

99 E State St
Gloversville, NY 12078-1203
Phone (518) 773-5780

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Port City Emergency Physicians LLP Physician Assistant CurrentSince Sep 13, 2022 Accepting new patients
Port City Emergency Physicians LLP Physician Assistant CurrentSince Sep 13, 2022 Accepting new patients
Wellnow Urgent Care, PC CurrentSince Mar 18, 2021 Accepting new patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Feb 1, 2020 Accepting new patients
Westchester Medical Center Past Accepting new patients

Locations

446 Fairview Ave
Ste 200
Hudson, NY 12534
Phone (518) 267-3496

7375 Oswego Rd
#1
Liverpool, NY 13090
Phone (315) 291-0064

110 W 6th St
Oswego, NY 13126
Phone (315) 349-5511

241 North Rd
Poughkeepsie, NY 12601
Phone (845) 431-8889

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/0e5efebe-b60c-458e-971a-ee39e08a2178/
  • Direct secure messaging: kalikhan468876@direct.uvmhealth.org

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 6

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": "1506902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1023528312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 MONROE ST",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120784119",
            "telephone_number": "518-844-4941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 E STATE ST",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120781203",
            "telephone_number": "518-725-8621"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 Nott St",
            "address_purpose": "LOCATION",
            "city": "Schenectady",
            "state": "NY",
            "postal_code": "123082425",
            "country_code": "US",
            "telephone_number": "518-243-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALI KHAN",
        "first_name": "KOUSAI",
        "middle_name": "O",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-02",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "021448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloversville, NY

Sources for this page

Verify at the official NPI Registry.