Individual provider Active NPI

Zulfiqar Khalique, M.D

  • Pediatrics Physician
  • Woodside, NY
National Provider Identifier
1366734436
Registry record updated Sep 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
261413 Issued in NY
Practice address
4757 43Rd St
Woodside, NY 11377-6243
Phone
(718) 706-1009
Fax
(718) 706-0777
NPI assigned
May 9, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 261413 NY Primary

Addresses

Primary practice location

4757 43Rd St
Woodside, NY 11377-6243

Mailing address

11 Belmont Blvd
Elmont, NY 11003-1804
Phone (646) 469-9596

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140410000006 NY Practitioner - Pediatric Medicine 5294997136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1300 Jericho Turnpike
Suite 207
New Hyde Park, NY 11040-4601

333 Jericho Tpke
Suite 102
Jericho, NY 11753-1104

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
261413NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wyckoff Emergency Medicine Services, P.C. CurrentSince Dec 21, 2017 Accepting new patients
Carnegie Hill Cardiology, PLLC PastSince Nov 1, 2006 Accepting new patients
Ideal Pediatric Care PC Past Accepting new patients
Marycare Physical Therapy P.C. Past Accepting new patients

Locations

374 Stockholm St
#137N
Brooklyn, NY 11237
Phone (718) 963-6485

Networks

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

Interoperability endpoints

  • Direct secure messaging: zulfiqar.khalique.2@14448.direct.athenahealth.com

Organizations & group practices 4

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": "1304899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441929600000",
    "number": "1366734436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 BELMONT BLVD",
            "city": "ELMONT",
            "state": "NY",
            "postal_code": "110031804",
            "telephone_number": "646-469-9596",
            "fax_number": "718-706-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4757 43RD ST",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113776243",
            "telephone_number": "718-706-1009",
            "fax_number": "718-706-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALIQUE",
        "first_name": "ZULFIQAR",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-09",
        "last_updated": "2015-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "261413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodside, NY

Sources for this page

Verify at the official NPI Registry.