Active NPI
Mukhtar I Khan, MD
- Endocrinology, Diabetes & Metabolism Physician
- Syracuse, NY
National Provider Identifier
1164463410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- License
- 213249
- Practice address
- 3229 E Genesee St
Joslin Center
Syracuse, NY 13214-2016 - Phone
- (315) 464-5726
- NPI assigned
- Jun 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 213249 | NY | |
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 213249 | NY | Primary |
Addresses
Primary practice location
3229 E Genesee St
Joslin Center
Syracuse, NY 13214-2016
Mailing address
3229 E Genesee St
Joslin Center
Syracuse, NY 13214-2016
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02161939 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 213249 | NY | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232496000000",
"number": "1164463410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3229 E GENESEE ST",
"address_2": "JOSLIN CENTER",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132142016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3229 E GENESEE ST",
"address_2": "JOSLIN CENTER",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132142016",
"telephone_number": "315-464-5726"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "MUKHTAR",
"middle_name": "I",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-09",
"last_updated": "2009-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "213249",
"primary": false
},
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "NY",
"license": "213249",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02161939",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.