Individual provider Active NPI

Altaf Khan, MD

  • Internal Medicine Physician
  • Richmond Hill, NY
National Provider Identifier
1215012901
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
117571 Issued in NY
Practice address
104-37 Lefferts Blvd
Richmond Hill, NY 11419-2709
Phone
(718) 322-8494
Fax
(718) 322-8495
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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 117571 NY Primary

Addresses

Primary practice location

104-37 Lefferts Blvd
Richmond Hill, NY 11419-2709

Mailing address

267-01 Hillside Ave
Floral Park, NY 11004-1743
Phone (718) 343-7790

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
I20070510000580 NY Practitioner - Internal Medicine 3375649122 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
117571NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Medical Provider PC CurrentSince Sep 1, 2015 Accepting new patients
Altaf a Khan Internal Medicine Past Accepting new patients

Locations

26701 Hillside Ave
Glen Oaks, NY 11004
Phone (347) 894-9531

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486598400000",
    "number": "1215012901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "267-01 HILLSIDE AVE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110041743",
            "telephone_number": "718-343-7790",
            "fax_number": "718-343-7792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104-37 LEFFERTS BLVD",
            "city": "RICHMOND HILL",
            "state": "NY",
            "postal_code": "114192709",
            "telephone_number": "718-322-8494",
            "fax_number": "718-322-8495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "ALTAF",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2017-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "117571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond Hill, NY

Sources for this page

Verify at the official NPI Registry.