Individual provider Active NPI

Shaleha Khalique, RN

  • Registered Nurse
  • New York, NY
National Provider Identifier
1083172688
Registry record updated Mar 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
681580 Issued in NY
Practice address
560 W 168TH St
New York, NY 10032-3917
Phone
(212) 305-5756
NPI assigned
Mar 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 681580 NY Primary

Addresses

Primary practice location

560 W 168TH St
New York, NY 10032-3917

Mailing address

2524 6TH Ave FL 2
East Meadow, NY 11554-3324
Phone (347) 282-6896

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260623000703 NY Practitioner - Certified Registered Nurse Anesthetist (Crna) 7911470893 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 1554
Stony Brook, NY 11790

PO Box
Suite 1554
Stony Brook, NY 11790-0988

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
681580NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
University Hospital at Stony Brook Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: shaleha.khalique@direct.stonybrookmedicine.edu

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1551657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551657600000",
    "number": "1083172688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2524 6TH AVE FL 2",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115543324",
            "telephone_number": "347-282-6896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323917",
            "telephone_number": "212-305-5756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIQUE",
        "first_name": "SHALEHA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-04",
        "last_updated": "2019-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "681580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.