South Asian Ipa, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

234133 Issued in NY

Legal business name

SOUTH ASIAN IPA, LLC

Practice address

530 Conduit Blvd
Suite - C
Brooklyn, NY 11208-3245

Phone

(718) 277-5500

Fax

(718) 277-2400

NPI assigned

Apr 21, 2017

Last updated

Apr 21, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Zaber Ahmad Khan, M.D.

Title

President

Phone

(646) 752-7058

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Central Queens Ipa,D/B/a South Asian Ipa

  dba South Asian IPA

  • Internal Medicine Physician
  • Jackson Heights, NY
  • NPI 1043752041
  NPPES parent name

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

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492732800000",
    "number": "1164957783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 CONDUIT BLVD",
            "address_2": "SUITE - C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112083245",
            "telephone_number": "718-277-5500",
            "fax_number": "718-277-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 CONDUIT BLVD",
            "address_2": "SUITE - C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112083245",
            "telephone_number": "718-277-5500",
            "fax_number": "718-277-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ASIAN IPA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-21",
        "last_updated": "2017-04-21",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "ZABER",
        "authorized_official_middle_name": "AHMAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-752-7058",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "234133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02807454",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sourcemedsupply Corporation
• Bonnie Sourkes
• Rochel Sourkes
• Ysroel Sourkes
• Andrew Soutar, DDS
• South Beach P.C
• South Beach Psychiatric Center
• South Beach Psychiatric Center
• South Beach Psychiatric Center
• South Brooklyn Health

• Primary Care Clinic/Center in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Primary Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.