NPIMap

Individual provider Active NPI

David Khasidy, M.D.

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1417995358
Registry record updated Jan 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
1630021 Issued in NY
Practice address
2797 Ocean Pkwy
2ND Floor
Brooklyn, NY 11235-7861
Phone
(718) 332-7111
Fax
(718) 332-7110
NPI assigned
Jun 3, 2006
Last updated
Jan 7, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1630021 NY Primary

Addresses

Primary practice location

2797 Ocean Pkwy
2ND Floor
Brooklyn, NY 11235-7861

Mailing address

2797 Ocean Pkwy
2ND Floor
Brooklyn, NY 11235-7861
Phone (718) 332-7111

Other identifiers 1

IdentifierTypeStateIssuer
00900367MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060622000161 NY Practitioner - Internal Medicine 9537171186 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Essen Medical Associates, PCGroup PAC ID 1759353501, 264 clinicians

Practice addresses (Care Compare)

11129 Queens Blvd
Forest Hills, NY 11375-5553
Phone (718) 275-8900

2015 Grand Ave
FL 1
Bronx, NY 10453-4611
Phone (718) 583-7736

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1630021NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intermed Care PC CurrentSince Mar 28, 2013 Accepting new patients
Intermed Care PC Internal Medicine CurrentSince Mar 28, 2013 Accepting new patients
Essen Medical Associates, PC Current Accepting new patients
Medex Diagnostic and Treatment Center LLC CurrentSince Nov 7, 2010 Accepting new patients
Essen Medical Associates,PC CurrentSince Mar 1, 2022 Accepting new patients
Essen Medical Associates, PC CurrentSince Mar 1, 2022 Accepting new patients
Essen Medical Urgicare, PLLC CurrentSince Mar 1, 2022 Accepting new patients
Well Plus Medical PC PastSince Aug 1, 2008 Accepting new patients
University Physicians Group P C Internal Medicine Past Accepting new patients
CT Physical Therapy Care, P.C. Past Accepting new patients
Win Medical, PLLC. Internal Medicine Past Accepting new patients
Astrocare Medical Services PC PastSince Sep 16, 2010 Accepting new patients

Locations

1550 Dr Martin L King Jr Blvd
Bronx, NY 10452
Phone (347) 269-2366

2015 Grand Concourse
Bronx, NY 10453
Phone (718) 294-6200

2505 Grand Ave
Bronx, NY 10468
Phone (718) 295-1400

3048 Brighton 1st St
Brooklyn, NY 11235
Phone (718) 368-1170

3048 Brighton 1st St
Ste 1
Brooklyn, NY 11235
Phone (718) 368-1170

11129 Queens Blvd
Forest Hills, NY 11375
Phone (718) 275-8900

8989 Union Tpke
Glendale, NY 11385
Phone (718) 480-6207

8989 Union Tpke
Ste A
Glendale, NY 11385
Phone (718) 746-0400

Networks

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

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 7

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": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199664000000",
    "number": "1417995358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2797 OCEAN PKWY",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112357861",
            "telephone_number": "718-332-7111",
            "fax_number": "718-332-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2797 OCEAN PKWY",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112357861",
            "telephone_number": "718-332-7111",
            "fax_number": "718-332-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHASIDY",
        "first_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2008-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "1630021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00900367",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.