Individual provider Active NPI

Imran Khalid, M.D.

  • Internal Medicine Physician
  • Staten Island, NY
National Provider Identifier
1407116551
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
265410 Issued in NY
Practice address
4771 Hylan Blvd
Staten Island, NY 10312-6315
Phone
(718) 948-8200
Fax
(718) 420-2718
NPI assigned
May 23, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 265410 NY Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 265410 NY

Addresses

Primary practice location

4771 Hylan Blvd
Staten Island, NY 10312-6315

Mailing address

55 Water St FL 2
New York, NY 10041-0010
Phone (646) 680-2888

Other practice location 1

375 Seguine Ave
Staten Island University Hospital (South)
Staten Island, NY 10309-3932
Phone (718) 226-4374

Other practice location 2

1050 Clove Rd
Staten Island, NY 10301-3627
Phone (718) 816-6440

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
I20121012000557 NY Practitioner - Internal Medicine 5092964742 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians
Advantagecare Physicians PCGroup PAC ID 2365735008, 307 clinicians

Practice addresses (Care Compare)

242 Mason Ave
Staten Island, NY 10305-3408
Phone (718) 226-6832

4771 Hylan Blvd
Staten Island, NY 10312-6315
Phone (718) 948-8200

Hospital & facility affiliations

  • North Shore Home Care Chha Home health agency, Westbury, NY, CCN 337148
  • Archcare at Home Home health agency, Valhalla, NY, CCN 337140
  • Staten Island University Hospital Hospital, Staten Island, NY, CCN 330160
  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
265410NYMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians of University Hospital, PC Internal Medicine CurrentSince Aug 1, 2012 Accepting new patients
Advantagecare Physicians PC CurrentSince Dec 28, 2016 Accepting new patients
North Shore-Lij Medical PC Internal Medicine CurrentSince Jun 1, 2019 Accepting new patients
Advantagecare Physicians PC Internal Medicine CurrentSince Dec 28, 2016 Accepting new patients
Physicians of University Hospital, PC CurrentSince Aug 1, 2012 Accepting new patients

Locations

233 Nostrand Ave
Brooklyn, NY 11205
Phone (646) 680-1595

55 Water St
Fl 2
New York, NY 10041

300 Community Dr
Plandome, NY 11030

375 Seguine Ave
Staten Island, NY 10309
Phone (718) 226-2000

1050 Clove Rd
Staten Island, NY 10301
Phone (718) 816-6440

242 Mason Ave
Staten Island, NY 10305
Phone (718) 226-1458

1 Edgewater St
Fl 6
Staten Island, NY 10305
Phone (718) 226-1047

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

401 Seaview Ave
Lowr
Staten Island, NY 10305
Phone (718) 226-6186

4771 Hylan Blvd
Staten Island, NY 10312
Phone (718) 948-8200

972 Brush Hollow Rd
Westbury, NY 11590

Networks

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

Interoperability endpoints

  • Direct secure messaging: ikhalid12447@direct.acpny.com
  • FHIR API: https://epwebapps.acpny.com/FHIRproxy/ACPNY/api/FHIR/R4
  • Direct secure messaging: ikhalid66222@northwell.direct-ci.com

Organizations & group practices 5

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1407116551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WATER ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100410010",
            "telephone_number": "646-680-2888",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4771 HYLAN BLVD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103126315",
            "telephone_number": "718-948-8200",
            "fax_number": "718-420-2718"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "375 Seguine Ave",
            "address_2": "Staten Island University Hospital (South)",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103093932",
            "country_code": "US",
            "telephone_number": "718-226-4374",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1050 Clove Rd",
            "address_purpose": "LOCATION",
            "city": "Staten Island",
            "state": "NY",
            "postal_code": "103013627",
            "country_code": "US",
            "telephone_number": "718-816-6440",
            "fax_number": "718-816-3611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHALID",
        "first_name": "IMRAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-23",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "265410",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NY",
            "license": "265410",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.