Individual provider Active NPI

Pallavi Khanna, MD

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1194287508
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
319035 Issued in NY
Practice address
279 E 3Rd St
New York, NY 10009-7813
Phone
(212) 749-1820
NPI assigned
Apr 3, 2019
Last updated
Sep 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 319035 NY Primary

Addresses

Primary practice location

279 E 3Rd St
New York, NY 10009-7813

Mailing address

123 Linden Blvd Apt 19D
Brooklyn, NY 11226-9711

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20221129003076 NY Practitioner - Internal Medicine 1557739364 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
319035NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
William F Ryan Community Health Center Inc CurrentSince Oct 10, 2022 Accepting new patients
William F Ryan Community Health Center Inc CurrentSince Oct 10, 2022 Accepting new patients
William F Ryan Community Health Center Inc Current Accepting new patients

Locations

110 W 97th St
New York, NY 10025
Phone (212) 316-7906

110 W 97th St
#0
New York, NY 10025

279 E 3rd St
New York, NY 10009
Phone (212) 477-8500

Interoperability endpoints

  • Direct secure messaging: pkhanna17578@prd.direct.tbh.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1194287508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 LINDEN BLVD APT 19D",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112269711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 E 3RD ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100097813",
            "telephone_number": "212-749-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHANNA",
        "first_name": "PALLAVI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-03",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "319035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.