Individual provider Active NPI

Rachel Khaldar, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1235867391
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
028540 Issued in NY
Practice address
535 W 110TH St Apt 1E
New York, NY 10025-2021
Phone
(212) 280-4740
NPI assigned
Aug 8, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 028540 NY Primary

Addresses

Primary practice location

535 W 110TH St Apt 1E
New York, NY 10025-2021

Mailing address

146 Pennington Ave
Passaic, NJ 07055-4714
Phone (301) 910-8097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230208000274 NY Practitioner - Physician Assistant 5092187682 Reassigns benefits to 1 organization
I20250911005226 NJ Practitioner - Physician Assistant 5092187682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

300 W 108TH St
Apt 13a
New York, NY 10025-2788

3725 Henry Hudson Pkwy
Apt 8C
Bronx, NY 10463-1507

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
028540NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Practice Associates Medical Group Single Specialty Past Accepting new patients
American Chiropractic Enterprise PLLC Single Specialty Past Accepting new patients

Networks

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

Organizations & group practices 3

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": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1235867391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 PENNINGTON AVE",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070554714",
            "telephone_number": "301-910-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 W 110TH ST APT 1E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100252021",
            "telephone_number": "212-280-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALDAR",
        "first_name": "RACHEL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-08",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "028540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.