Active NPI
Abu N.G.a. Khan, MD, MSC
- Pediatric Emergency Medicine (Pediatrics) Physician
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Emergency Medicine (Pediatrics) Physician
- License
- 200732
- Practice address
- 622 W 168TH St PH 260
New York, NY 10032-3720 - Phone
- (212) 305-9825
- Fax
- (212) 544-1974
- NPI assigned
- Mar 21, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Emergency Medicine (Pediatrics) Physician | 2080P0204X | 200732 | NY | Primary |
Addresses
Primary practice location
622 W 168TH St PH 260
New York, NY 10032-3720
Mailing address
227 Sheridan Ave
Mount Vernon, NY 10552-1406
Phone (718) 796-0682
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01642382 | Medicaid | NY |
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxypub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) | |
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ | Health Information Exchange (HIE) | |
| Direct Messaging Address | Khanabu@direct.nyp.org | Direct |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Pediatric Emergency Medicine | Current | Accepting new patients |
| Maimonides Medical Center - MMC Emergency Physicians FPP | Past | Accepting new patients |
Locations
630 W 168th St
New York, NY 10032
Phone (212) 305-1948
622 W 168th St
Ph 260
New York, NY 10032
Phone (212) 305-9825
3959 Broadway
New York, NY 10032
Phone (212) 304-7297
622 W 168th St
Ph 137
New York, NY 10032
Phone (212) 305-3232
622 W 168th St
New York, NY 10032
Phone (212) 305-4931
161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559
622 W 168th St
#1624
New York, NY 10032
2026 Richmond Rd
Staten Island, NY 10306
Phone (212) 305-2300
967 N Broadway
Yonkers, NY 10701
Phone (914) 798-8956
Interoperability endpoints
- khanabu@direct.nyp.org
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
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 and National Provider Directory roles.
-
- Surgery Physician
- New York, NY
- NPI 1508266347
-
- Internal Medicine Physician
- New York, NY
- NPI 1699289488
Pediatric Emergency Medicine
-
- Emergency Medicine Physician
- Brooklyn, NY
- NPI 1982708202
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692921600000",
"number": "1194784074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "227 SHERIDAN AVE",
"city": "MOUNT VERNON",
"state": "NY",
"postal_code": "105521406",
"telephone_number": "718-796-0682"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "622 W 168TH ST PH 260",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100323720",
"telephone_number": "212-305-9825",
"fax_number": "212-544-1974"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHAN",
"first_name": "ABU",
"middle_name": "N.G.A.",
"name_prefix": "Dr.",
"credential": "MD, MSC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-21",
"last_updated": "2023-08-25",
"certification_date": "2023-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0204X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Emergency Medicine",
"state": "NY",
"license": "200732",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01642382",
"state": "NY"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxypub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "622 W 168th St Ph 260",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100323720",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "622 W 168th St Ph 260",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100323720",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Khanabu@direct.nyp.org",
"affiliation": "N",
"endpointDescription": "Direct Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Direct Address",
"address_1": "622 W 168th St Ph 260",
"city": "New York",
"state": "NY",
"country_code": "US",
"postal_code": "100323720",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.