Individual provider Active NPI

Afsar Ali Khan, MD

  • Emergency Medicine Physician
  • Utica, NY
National Provider Identifier
1396788824
Registry record updated Jul 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
221685-1 Issued in NY
Practice address
2209 Genesee St
Utica, NY 13501-5930
Phone
(315) 798-8111
Fax
(315) 734-3158
NPI assigned
Jun 13, 2006
Last updated
Jul 12, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 221685-1 NY Primary

Addresses

Primary practice location

2209 Genesee St
Utica, NY 13501-5930

Mailing address

307 S Evergreen Ave
Woodbury, NJ 08096-2739
Phone (856) 686-4300

Other identifiers 1

IdentifierTypeStateIssuer
02167884MedicaidNJ

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
I20041004000809 NY Practitioner - Family Practice 9335108695 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
221685-1NYMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physician Services of New York, P.C. Emergency Medicine CurrentSince Oct 1, 2004 Accepting new patients
MVHS Inc CurrentSince Feb 29, 2012 Accepting new patients
Emergency Care Services of New York, P.C. Emergency Medicine CurrentSince Jan 1, 2007 Accepting new patients
MVHS Inc CurrentSince Feb 29, 2012 Accepting new patients

Locations

307 S Evergreen Ave
Woodbury, NJ 08096
Phone (856) 686-4300

427 Guy Park Ave
Amsterdam, NY 12010
Phone (518) 442-1404

396 Broadway
Kingston, NY 12401
Phone (845) 331-3131

140 Burwell St
Little Falls, NY 13365
Phone (315) 823-1000

4401 Middle Settlement Rd
New Hartford, NY 13413
Phone (315) 734-3471

321 Genesee St
Oneida, NY 13421
Phone (315) 361-2020

301 Prospect Ave
Syracuse, NY 13203
Phone (315) 448-5111

120 Hobart St
Utica, NY 13501
Phone (315) 798-1149

1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567

2209 Genesee St
Utica, NY 13501
Phone (315) 798-8100

Interoperability endpoints

  • Direct secure messaging: akhan13064@mvhealthsystem.direct-ci.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, 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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1396788824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S EVERGREEN AVE",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080962739",
            "telephone_number": "856-686-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135015930",
            "telephone_number": "315-798-8111",
            "fax_number": "315-734-3158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "AFSAR",
        "middle_name": "ALI",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "221685-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02167884",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.