Individual provider Active NPI

Dana K Khuthaila, MD

  • Plastic Surgery Physician
  • New York, NY
National Provider Identifier
1376857136
Registry record updated Aug 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
255932 Issued in NY
Practice address
830 Park Ave
New York, NY 10021-2757
Phone
(212) 810-9052
NPI assigned
Aug 3, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 255932 NY Primary

Addresses

Primary practice location

830 Park Ave
New York, NY 10021-2757

Mailing address

30 Central Park S
RM 11B
New York, NY 10019-1648
CA
Phone (212) 810-9052

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: dkhuthaila67998@northwell.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1280793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472428800000",
    "number": "1376857136",
    "addresses": [
        {
            "country_code": "CA",
            "country_name": "Canada",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "30 CENTRAL PARK S",
            "address_2": "RM 11B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191648",
            "telephone_number": "212-810-9052",
            "fax_number": "212-750-2849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 PARK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100212757",
            "telephone_number": "212-810-9052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHUTHAILA",
        "first_name": "DANA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-03",
        "last_updated": "2016-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "255932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.