Active NPI
Maksuda Khan Tania
- Internal Medicine Physician
- Jamaica, NY
National Provider Identifier
1447081567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- P128347
- Practice address
- 8900 Van Wyck Expy
Jamaica, NY 11418-2832 - Phone
- (718) 206-6290
- NPI assigned
- Aug 10, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | P128347 | NY | Primary |
Addresses
Primary practice location
8900 Van Wyck Expy
Jamaica, NY 11418-2832
Mailing address
2617 Halperin Ave Apt B6
Bronx, NY 10461-2666
Phone (347) 712-8435
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251025000582 | SC | Order and Referring Only - Internal Medicine | 3274022777 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P128347 | NY | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723248000000",
"number": "1447081567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2617 HALPERIN AVE APT B6",
"city": "BRONX",
"state": "NY",
"postal_code": "104612666",
"telephone_number": "347-712-8435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8900 VAN WYCK EXPY",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114182832",
"telephone_number": "718-206-6290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANIA",
"first_name": "MAKSUDA",
"middle_name": "KHAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-08-10",
"last_updated": "2024-08-10",
"certification_date": "2024-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "NY",
"license": "P128347",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.