NPIMap

Individual provider Active NPI

Johnathan Alexander Khusid, M.D. (MAY 2015)

  • Urology Physician
  • New York, NY
National Provider Identifier
1124413364
Registry record updated Mar 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
303651-01 Issued in NY
Practice address
1 Gustave L Levy PL
New York, NY 10029
Phone
(212) 241-4812
NPI assigned
Apr 4, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 303651-01 NY Primary

Addresses

Primary practice location

1 Gustave L Levy PL
New York, NY 10029

Mailing address

1 Gustave L Levy PL
New York, NY 10029-6504
Phone (212) 241-4812

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
I20210329001392 NY Practitioner - Urology 4284041724 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
CHS Physician Partners PCGroup PAC ID 7618955667, 739 clinicians

Practice addresses (Care Compare)

2200 Northern Blvd
Suite 120
Greenvale, NY 11548-1220
Phone (631) 465-6431

One Gustave L Levy Place
New York, NY 10029-6574
Phone (212) 241-0045

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
303651-01NYMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHS Physician Partners, PC CurrentSince Jan 19, 2026 Accepting new patients
CHS Physician Partners, P.C CurrentSince Jan 19, 2026 Accepting new patients
Icahn School of Medicine at Mount Sinai Urology CurrentSince Jun 1, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jun 1, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Mount Sinai Hospital Past Accepting new patients

Locations

2200 Northern Blvd
Ste 120
Greenvale, NY 11548
Phone (631) 465-6431

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012

100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385

100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800

Networks

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

Organizations & group practices 8

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.

Hospital & facility affiliations 11

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": "1428105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1124413364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296504",
            "telephone_number": "212-241-4812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GUSTAVE L LEVY PL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10029",
            "telephone_number": "212-241-4812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHUSID",
        "first_name": "JOHNATHAN",
        "middle_name": "ALEXANDER",
        "name_prefix": "Mr.",
        "credential": "M.D. (MAY 2015)",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-04",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NY",
            "license": "303651-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.