Individual provider Active NPI

Kashif Iqubal, MD

  • Pediatrics Physician
  • Flushing, NY
National Provider Identifier
1255853180
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
305519-01 Issued in NY
Practice address
4500 Parsons Blvd
Flushing, NY 11355
Phone
(718) 670-5584
NPI assigned
Jul 12, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 305519-01 NY Primary

Addresses

Primary practice location

4500 Parsons Blvd
Flushing, NY 11355

Mailing address

33 Hudson St Apt 3104E
Jersey City, NJ 07302-6597
Phone (848) 218-8243

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231012001150 NY Practitioner - Pediatric Medicine 0446595524 Reassigns benefits to 2 organizations
I20240906000123 NY Practitioner - Obstetrics/Gynecology 0446595524 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
305519-01NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jul 8, 2024 Accepting new patients
North Shore-Lij Medical PC CurrentSince Aug 20, 2023 Accepting new patients
New York University Pediatrics CurrentSince Jul 8, 2024 Accepting new patients
North Shore - Lij Medical PC CurrentSince Aug 20, 2023 Accepting new patients
Staten Island University Hospital Past Accepting new patients
Lenox Hill Hospital Past Accepting new patients

Locations

700 Hicksville Rd
Ste 205
Bethpage, NY 11714
Phone (646) 501-3325

4500 Parsons Blvd
Flushing, NY 11355
Phone (718) 670-5631

100 E 77th St
New York, NY 10075
Phone (212) 434-2606

300 Community Dr
Plandome, NY 11030

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: kashifiqubal@nslijmedgr.allscriptsdirect.net
  • Direct secure messaging: kiqubal66856@northwell.direct-ci.com

Organizations & group practices 6

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": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1255853180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 HUDSON ST APT 3104E",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073026597",
            "telephone_number": "848-218-8243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 PARSONS BLVD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11355",
            "telephone_number": "718-670-5584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IQUBAL",
        "first_name": "KASHIF",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-12",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "305519-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.