Khadiga Ahmed, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

329788 Issued in NY

Practice address

640 Hawkins Ave
Lake Ronkonkoma, NY 11779-2324

Phone

(631) 471-0100

Fax

(631) 471-1000

NPI assigned

Apr 5, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Family Practice

Education

New York College of Osteo Medicine of New York Institute of Technology, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advantagecare Physicians PCGroup PAC ID 2365735008, 307 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4
• Direct secure messaging: kahmed53860@direct.acpny.com

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.

• Advantagecare Physicians PC

  • General Practice Physician
  • New York, NY
  • NPI 1336578772
  Medicare reassignment Care Compare group NPD
• Advantagecare Physicians PC

  • Internal Medicine Physician
  • Staten Island, NY
  • NPI 1063954113

  Family Medicine

  NPD

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1053817296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WATER ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100410010",
            "telephone_number": "646-680-2888",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 HAWKINS AVE",
            "city": "LAKE RONKONKOMA",
            "state": "NY",
            "postal_code": "117792324",
            "telephone_number": "631-471-0100",
            "fax_number": "631-471-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "KHADIGA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-05",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "329788",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "288031",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Abbott, RN
• Frank Thomas Adam, O.D.
• Salma Afroze, DO
• Dawn Marie Agnese Diaz, PT
• Anisa Ali-Perez, PA
• Sabrina Amature
• Patricia Auletta
• Michelle Bagliore
• Julianne Bartlett, M.ED., CAS

• Family Medicine Physician in Lake Ronkonkoma, NY
• Providers in Lake Ronkonkoma, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.