Khaula Khalid, DO

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

25MB08277700 Issued in NJ

Practice address

946 Bloomfield Ave
Glen Ridge, NJ 07028-1308

Phone

(973) 743-1121

NPI assigned

May 6, 2008

Last updated

Apr 5, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NJ

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

Specialty

Cardiovascular Disease (Cardiology)

Education

New York College of Osteo Medicine of New York Institute of Technology, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Optum Medical Care of New Jersey PCGroup PAC ID 3072650290, 168 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Newark Beth Israel Medical Center Hospital, Newark, NJ, CCN 310002

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kkhalid77177@direct.optum.com

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.

• Optum Medical Care of New Jersey PC

  • Pediatrics Physician
  • New Hyde Park, NY
  • NPI 1578665048

  Internal Medicine, NJ

  Medicare reassignment Care Compare group NPD
• Browne Medical, LLC

  • Urgent Care Clinic/Center
  • South Plainfield, NJ
  • NPI 1851733349
  Medicare reassignment NPD
• Holmdel Physician Associates

  • Hospitalist Physician
  • Freehold, NJ
  • NPI 1346647328
  Medicare reassignment NPD
• Liberty Med Associates LLC

  • Internal Medicine Physician
  • Holmdel, NJ
  • NPI 1366983033
  Medicare reassignment NPD
• SKR Medical Advisors

  • Urgent Care Clinic/Center
  • Lyndhurst, NJ
  • NPI 1184971558
  Medicare reassignment NPD
• Two River Physician Associates

  • Diagnostic Radiology Physician
  • Red Bank, NJ
  • NPI 1417354333
  Medicare reassignment NPD
• Optum Medical Care of New Jersey PC

  dba Riverside Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Belleville, NJ
  • NPI 1255050902
  NPD
• Browne Medical, LLC

  • Urgent Care Clinic/Center
  • West Orange, NJ
  • NPI 1871935353
  NPD (past)
• Riverside Medical Group

  • Nurse Practitioner
  • Secaucus, NJ
  • NPI 1053867598
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Newark Beth Israel Medical Center Inc

  dba Newark Beth Israel Medical Center

  • General Acute Care Hospital
  • Newark, NJ
  • NPI 1215027966
  Care Compare affiliation

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301961600000",
    "number": "1164698445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "946 BLOOMFIELD AVE",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070281308",
            "telephone_number": "973-743-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "946 BLOOMFIELD AVE",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070281308",
            "telephone_number": "973-743-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALID",
        "first_name": "KHAULA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-06",
        "last_updated": "2011-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB08277700",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NJ",
            "license": "25MB08277700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHP NON PAR #",
            "identifier": "47928",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0167428",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00650715",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pande Vasil Josifovski, M.D.
• Maria Belen Jumalon, APN
• Anabela Kalliney, APN
• Kathrine Berdebes Kent, MS RD
• Mikhail I. Khaimov, D.O.
• Mazin Khalid, MD
• Khanna Nephrology, L.L.C.
• Khanna Pediatrics, LLC
• Anisha Khanna, D.O.
• Kamlesh Khanna, MD

• Cardiovascular Disease Physician in Glen Ridge, NJ
• Providers in Glen Ridge, NJ by specialty
• Cardiovascular Disease Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; 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.

Verify at the official NPI Registry.