New York Interventional Spine and Pain Medicine PC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

License

251646 Issued in NY

Legal business name

NEW YORK INTERVENTIONAL SPINE AND PAIN MEDICINE PC

Practice address

405 5TH Ave
Brooklyn, NY 11215-3315

Phone

(646) 732-7139

Fax

(718) 768-7303

NPI assigned

Jul 20, 2012

Last updated

Aug 3, 2021By 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

Abdulquader Khan, MDNPI 1013146216

Title

President

Phone

(646) 732-7139

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Practitioners 3

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.

• Abdulquader Khan, M.D.

  • Pain Medicine Physician
  • Brooklyn, NY
  • NPI 1013146216
  Medicare reassignment NPD Authorized official
• Nasimullah Khan, MD

  • Family Medicine Physician
  • Brooklyn, NY
  • NPI 1477947711
  Medicare reassignment NPD
• Rhoderick James Manhattan, PA-C

  • Physician Assistant
  • St Petersburg, FL
  • NPI 1285678227

  NY

  Medicare reassignment

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

{
    "created_epoch": "1342742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627948800000",
    "number": "1235484726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153315",
            "telephone_number": "646-732-7139",
            "fax_number": "718-768-7303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 5TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112153315",
            "telephone_number": "646-732-7139",
            "fax_number": "718-768-7303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK INTERVENTIONAL SPINE AND PAIN MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-20",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "ABDULQUADER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-732-7139",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NY",
            "license": "251646",
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "NY",
            "license": "251646",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "000135",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "003681",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03289269",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• New York Hou Fu Senior Center Inc
• New York Infinity Health Care, CSW, P.C.
• New York Integrated Network for Persons With Developmentaldisabilities
• New York Integrative Rheumatology (New Tork Integrative Rheumatology)
• New York Interventional Pain Management, P.C. (Greenwood Medical Center, P.C.)
• New York Jewish American Podiatry Practice PLLC
• New York Kidney Care PLLC
• New York Laser Eye LLP
• New York League for Early Learning
• New York League for Early Learning, William O'Connor School

• Pain Clinic/Center in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Pain Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; 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.