Active NPI
Levan Khasidy, MD
- Urology Physician
- Forest Hills, NY
National Provider Identifier
1073607727
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 160993
- Practice address
- 11115 Queens Blvd
2ND FL
Forest Hills, NY 11375-7422 - Phone
- (718) 520-2300
- Fax
- (718) 520-4440
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 160993 | NY | Primary |
Addresses
Primary practice location
11115 Queens Blvd
2ND FL
Forest Hills, NY 11375-7422
Mailing address
111-15 Queens Blvd
2ND FL
Forest Hills, NY 11375-7422
Phone (718) 520-2300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Urology
- Education
- Other, 1972
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
11115 Queens Blvd
Forest Hills, NY 11375-7422
Phone (718) 520-2300
4035 95TH St
Elmhurst, NY 11373-6206
Phone (718) 520-2300
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elite 23 Holding Group LLC | Current | Accepting new patients | |
| Michael Z Weiner MDPC | Past | Accepting new patients | |
| Suny Downstate Medical Center | Past | Accepting new patients | |
| Century Medical & Dental Center Inc | Past | Accepting new patients | |
| SVS Wellcare Medical PLLC | Past | Accepting new patients | |
| Provider Medical Care PC | Past | Accepting new patients |
Locations
202 Sunny Isles Blvd
Ste 8A
Sunny Isles Beach, FL 33160
Phone (305) 523-9787
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
Organizations & group practices 10
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.
-
- Urology Physician
- Forest Hills, NY
- NPI 1902999428
-
dba Elite Medical Center
- Multi-Specialty Clinic/Center
- Sunny Isles Beach, FL
- NPI 1598592537
-
- Surgery Physician
- New York, NY
- NPI 1780308106
-
- Internal Medicine Physician
- Englishtown, NJ
- NPI 1255131470
NY
-
- Internal Medicine Physician
- North Miami Beach, FL
- NPI 1881571156
-
- Health Service Clinic/Center
- Brooklyn, NY
- NPI 1144399098
-
- Cardiovascular Disease Physician
- Forest Hills, NY
- NPI 1346325057
-
- Family Medicine Physician
- Brooklyn, NY
- NPI 1346472495
-
- Emergency Medicine Physician
- Brooklyn, NY
- NPI 1699704155
-
- Rehabilitation Practitioner
- Brooklyn, NY
- NPI 1154350361
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215993600000",
"number": "1073607727",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111-15 QUEENS BLVD",
"address_2": "2ND FL",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113757422",
"telephone_number": "718-520-2300",
"fax_number": "718-520-4440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11115 QUEENS BLVD",
"address_2": "2ND FL",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113757422",
"telephone_number": "718-520-2300",
"fax_number": "718-520-4440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHASIDY",
"first_name": "LEVAN",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2008-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "NY",
"license": "160993",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; 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.