Active NPI
Krishna Swarube Haridasan, MD
- Internal Medicine Physician
- Brooklyn, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD485264
- Practice address
- 121 Dekalb Ave
Brooklyn, NY 11201-5425 - Phone
- (718) 250-6604
- NPI assigned
- Apr 9, 2021
- Last updated
- Oct 6, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 84109 | CT | |
| Internal Medicine Physician | 207R00000X | 331324 | NY | |
| Internal Medicine Physician | 207R00000X | MD485264 | PA | Primary |
Addresses
Primary practice location
121 Dekalb Ave
Brooklyn, NY 11201-5425
Mailing address
121 Dekalb Ave
Brooklyn, NY 11201-5425
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA, NY, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
111 Hospital Dr
Utica, NY 13502-2517
Phone (315) 917-9966
800 E Carpenter St
Springfield, IL 62702-5324
Phone (217) 544-6464
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 84109 | CT | MD | Internal Medicine Physician |
| MD485264 | PA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oncology Hematology Associates of Northern Illinois, LTD | Current | Accepting new patients | |
| Waukegan Clinic Corp | Internal Medicine | Current | Accepting new patients |
| New York Medical Physician Associates PC | Current | Accepting new patients | |
| Apogee Medical Group of Pennsylvania PC | Internal Medicine | Current | Accepting new patients |
| New York Medical Physician Associates PC | Internal Medicine | Current | Accepting new patients |
| New York Medical Physician Associates PC | Current | Accepting new patients | |
| Apogee Medical Group of Pennsylvania PC | Internal Medicine | Current | Accepting new patients |
| MVHS Inc | Past | Accepting new patients | |
| MVHS Inc | Past | Accepting new patients |
Locations
2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125
200 S Greenleaf St
Ste L
Gurnee, IL 60031
Phone (847) 360-7888
1324 N Sheridan Rd
Waukegan, IL 60085
Phone (847) 360-3000
111 Hospital Dr
Utica, NY 13502
Phone (315) 801-8534
100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040
1086 Franklin St
Johnstown, PA 15905
Phone (610) 250-4540
Interoperability endpoints
- https://api.platform.athenahealth.com/2069/brand/1/csg/29/fhir/r4
- kharidasan18449@prd.direct.tbh.org
Organizations & group practices 10
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.
-
- Hospitalist Physician
- Poughkeepsie, NY
- NPI 1578316501
Internal Medicine
-
- Internal Medicine Physician
- Belleville, IL
- NPI 1841613403
-
- Internal Medicine Physician
- Scottsdale, AZ
- NPI 1568633535
PA
-
- Hospitalist Physician
- Margaretville, NY
- NPI 1528869203
-
- Hospitalist Physician
- Utica, NY
- NPI 1619722147
-
- Internal Medicine Physician
- Scottsdale, AZ
- NPI 1649227166
-
- Hematology & Oncology Physician
- Gurnee, IL
- NPI 1093142135
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Carlinville Area Hospital
- Critical Access Hospital
- Carlinville, IL
- NPI 1053425124
-
- Critical Access Hospital
- Shelbyville, IL
- NPI 1053348532
-
dba St. Anthony's Memorial Hospital
- General Acute Care Hospital
- Effingham, IL
- NPI 1306800602
-
dba St. Anthony's Memorial Hospitral
- Clinic/Center
- Effingham, IL
- NPI 1881214104
Hospital
-
dba HSHS St. John's Hospital
- General Acute Care Hospital
- Springfield, IL
- NPI 1205818481
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1617926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1791244800000",
"number": "1487234985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 DEKALB AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112015425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 DEKALB AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112015425",
"telephone_number": "718-250-6604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARIDASAN",
"first_name": "KRISHNA",
"middle_name": "SWARUBE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-09",
"last_updated": "2026-10-06",
"certification_date": "2026-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CT",
"license": "84109",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "331324",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MD485264",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.