Khondker Farhana Moin, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

BP10089351 Issued in TX

Practice address

1400 S Coulter St Ste 2500
Amarillo, TX 79106-1786

Phone

(806) 414-9100

Fax

(806) 354-5717

NPI assigned

Mar 19, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1225898398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9734 E 73RD ST APT 510",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741333226",
            "telephone_number": "405-780-3942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S COULTER ST STE 2500",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791061786",
            "telephone_number": "806-414-9100",
            "fax_number": "806-354-5717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44 Nassau Dr",
            "address_purpose": "LOCATION",
            "city": "Great Neck",
            "state": "NY",
            "postal_code": "110211441",
            "country_code": "US",
            "telephone_number": "516-402-4884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOIN",
        "first_name": "KHONDKER FARHANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "P127561",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10089351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryleigh Moffitt, RD, LD
• Basheer Umar Mohammed, MD
• Sayyidda Fareeaa Mohammed, M.D.
• Balaji Prasad Ellapp Mohanakrishnan, MD
• Karen R Mohn, N.P.
• Adrian Mola de la Rosa, MD
• Kayla Leigh Money, PHARM.D.
• Haley Monfort, APRN
• Virginia L Monk, LPC
• Tenisha Montague

• Student in an Organized Health Care Education/Training Program in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Student in an Organized Health Care Education/Training Program in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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.

Verify at the official NPI Registry.