Individual provider Active NPI

Fatima M Khan, MD

  • Rheumatology Physician
  • Floral Park, NY
National Provider Identifier
1407070667
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
268169 Issued in NY
Practice address
26701 Hillside Ave
Floral Park, NY 11004-1743
Phone
(718) 343-7790
Fax
(718) 343-7792
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X E-5465 AR
Student in an Organized Health Care Education/Training Program 390200000X AR
Rheumatology Physician 207RR0500X 268169 NY Primary

Addresses

Primary practice location

26701 Hillside Ave
Floral Park, NY 11004-1743

Mailing address

26701 Hillside Ave
Floral Park, NY 11004-1743
Phone (718) 343-7790

Other identifiers 1

IdentifierTypeStateIssuer
04222428MedicaidNY

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
I20150407000047 NY Practitioner - Rheumatology 6406174382 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

26701 Hillside Ave
Floral Park, NY 11004-1743
Phone (501) 766-4777

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-5465ARMDInternal Medicine Physician
268169NYMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PS Medical Care of Elmont PLLC Rheumatology CurrentSince Nov 23, 2024 Accepting new patients
Qadri Medical PC Rheumatology CurrentSince Apr 7, 2018 Accepting new patients
Quality Medical Provider PC CurrentSince Jan 1, 2015 Accepting new patients

Locations

20B Meacham Ave
Elmont, NY 11003
Phone (516) 502-9355

905 Hempstead Tpke
Franklin Square, NY 11010
Phone (516) 492-3201

26701 Hillside Ave
Glen Oaks, NY 11004
Phone (347) 894-9531

10913 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 441-6048

Networks

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1407070667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26701 HILLSIDE AVE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110041743",
            "telephone_number": "718-343-7790",
            "fax_number": "718-343-7792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26701 HILLSIDE AVE",
            "city": "FLORAL PARK",
            "state": "NY",
            "postal_code": "110041743",
            "telephone_number": "718-343-7790",
            "fax_number": "718-343-7792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "FATIMA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AR",
            "license": "E-5465",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AR",
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NY",
            "license": "268169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04222428",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Floral Park, NY

Sources for this page

Verify at the official NPI Registry.