Individual provider Active NPI

Ruwaydah Khan

  • Physician Assistant
  • Forest Hills, NY
National Provider Identifier
1356158620
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
7049 Austin St
Forest Hills, NY 11375-1033
Phone
(718) 280-1245
NPI assigned
Dec 11, 2024
Last updated
Dec 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

7049 Austin St
Forest Hills, NY 11375-1033

Mailing address

8824 209TH St
Queens Village, NY 11427-2221
Phone (347) 400-1939

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
I20250207001456 NY Practitioner - Physician Assistant 7214467158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10202 Liberty Ave
Ozone Park, NY 11417-1727
Phone (718) 571-9265

13030 Farmers Blvd
Jamaica, NY 11434-4122
Phone (646) 518-8263

3111 Steinway St
Astoria, NY 11103-3908
Phone (718) 475-2345

6118 188TH St
Fresh Meadows, NY 11365-2713
Phone (718) 489-5003

7049 Austin St
Forest Hills, NY 11375-1033
Phone (718) 280-1245

7425 Grand Ave
Elmhurst, NY 11373-4126
Phone (718) 803-2273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
033046NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
City Medical of Upper East Side, PLLC CurrentSince Jan 9, 2025 Accepting new patients
City Medical of Upper East Side, PLLC CurrentSince Jan 9, 2025 Accepting new patients

Locations

3111 Steinway St
Astoria, NY 11103
Phone (718) 475-2345

7049 Austin St
Forest Hills, NY 11375
Phone (718) 280-1245

336 E 86th St
New York, NY 10028
Phone (212) 772-3627

Interoperability endpoints

  • Direct secure messaging: ruwaydah.khan.1@2983.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1733875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1356158620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8824 209TH ST",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114272221",
            "telephone_number": "347-400-1939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7049 AUSTIN ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751033",
            "telephone_number": "718-280-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "RUWAYDAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-11",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.