PS Medical Care of Elmont PLLC

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

Legal business name

PS MEDICAL CARE OF ELMONT PLLC

Practice address

20B Meacham Ave
Elmont, NY 11003-2654

Phone

(516) 502-9355

Fax

(888) 858-2068

NPI assigned

Jul 3, 2017

Last updated

Dec 2, 2024By 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. Fatima Khan, MDNPI 1407070667

Title

Administrator

Phone

(501) 766-4777

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Fatima M Khan, MD

  • Rheumatology Physician
  • Floral Park, NY
  • NPI 1407070667
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1499040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733097600000",
    "number": "1225559990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20B MEACHAM AVE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110032654",
            "telephone_number": "516-502-9355",
            "fax_number": "888-858-2068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20B MEACHAM AVE",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110032654",
            "telephone_number": "516-502-9355",
            "fax_number": "888-858-2068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PS MEDICAL CARE OF ELMONT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-03",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "FATIMA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "501-766-4777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "268169",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kerwayne H Probherbs, M.D.
• Professional Balance Physical Therapy, PLLC
• Tanya Pruden
• Myriam Prudhomme
• Patricia Pryce
• Nancy Pugo
• Crystal Janice Purcell, RN
• David Shelton Purcell, RN
• Princeness Purcell, LPN
• Claudia Pyke

• Rheumatology Physician in Elmont, NY
• Providers in Elmont, NY by specialty
• Rheumatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.