Individual provider Active NPI

Khalil Gelin, FNP-BC

  • Family Nurse Practitioner
  • Bronx, NY
National Provider Identifier
1225691744
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
344077 Issued in NY
Practice address
1650 Grand Concourse
Bronx, NY 10457-7606
Phone
(718) 992-7669
NPI assigned
Apr 19, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 344077 NY Primary

Addresses

Primary practice location

1650 Grand Concourse
Bronx, NY 10457-7606

Mailing address

1276 Fulton Ave RM 219
Bronx, NY 10456-3402
Phone (718) 992-7669

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210603001635 NY Practitioner - Nurse Practitioner 3072912542 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bronxcare Health System CurrentSince Apr 13, 2021 Accepting new patients
Bronxcare Health System CurrentSince Apr 13, 2021 Accepting new patients

Locations

1650 Grand Concourse
Bronx, NY 10457
Phone (718) 294-7104

1276 Fulton Ave
Rm 219
Bronx, NY 10456

Interoperability endpoints

  • Direct secure messaging: kgelin@landmarkhealth-direct.org

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": "1555632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1225691744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE RM 219",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402",
            "telephone_number": "718-992-7669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 GRAND CONCOURSE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104577606",
            "telephone_number": "718-992-7669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELIN",
        "first_name": "KHALIL",
        "name_prefix": "Mr.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-19",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "344077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.