Individual provider Active NPI

Sharon Kheradnam

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1063823664
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
291764 Issued in NY
Practice address
1 Brookdale PLZ
Brooklyn, NY 11212-3139
Phone
(718) 240-5000
NPI assigned
May 16, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 291764 NY Primary

Addresses

Primary practice location

1 Brookdale PLZ
Brooklyn, NY 11212-3139

Mailing address

1247 E 9TH St
Brooklyn, NY 11230-5107
Phone (347) 870-4732

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210629003539 NY Practitioner - Internal Medicine 2567715378 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Corona Medical PCGroup PAC ID 0749421279, 3 clinicians
Parcare Community Health Network IncGroup PAC ID 4981823390, 99 clinicians

Practice addresses (Care Compare)

1648 E 14TH St
Suite 1
Brooklyn, NY 11229-1175
Phone (718) 998-2350

445 Park Ave
Brooklyn, NY 11205-2735
Phone (718) 963-0800

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bitachon 412 LLC Internal Medicine CurrentSince May 28, 2025 Accepting new patients
Maimonides Medical Center Current Accepting new patients
Unity Medical Care PLLC Internal Medicine Current Accepting new patients
Parcare Community Health Network Inc CurrentSince Sep 1, 2022 Accepting new patients
Parcare Community Health Network Inc CurrentSince Sep 1, 2022 Accepting new patients
Corona Medical PC Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients

Locations

4714 16th Ave
Brooklyn, NY 11204
Phone (212) 604-9800

1648 E 14th St
Ste 1
Brooklyn, NY 11229
Phone (718) 998-2350

445 Park Ave
Brooklyn, NY 11205
Phone (718) 965-1320

623 Middle Neck Rd
Great Neck, NY 11023
Phone (516) 730-8990

Networks

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

Interoperability endpoints

  • Direct secure messaging: skheradnam564205@nychhc.direct-ci.com
  • Direct secure messaging: sharonkheradnam@mai.allscriptsdirect.net

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1400198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1063823664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1247 E 9TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305107",
            "telephone_number": "347-870-4732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BROOKDALE PLZ",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112123139",
            "telephone_number": "718-240-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHERADNAM",
        "first_name": "SHARON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-16",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "291764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.