Individual provider Active NPI

Krishna Swarube Haridasan, MD

  • Internal Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1487234985
Registry record updated Oct 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD485264 Issued in PA
Practice address
121 Dekalb Ave
Brooklyn, NY 11201-5425
Phone
(718) 250-6604
NPI assigned
Apr 9, 2021
Last updated
Oct 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2026

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 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, IL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20240618002889 PA Practitioner - Internal Medicine 7810430865 Reassigns benefits to 1 organization
I20250205001339 NY Practitioner - Hospitalist 7810430865 Reassigns benefits to 1 organization
I20250513003334 IL Practitioner - Hospitalist 7810430865 Reassigns benefits to 2 organizations

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

LicenseStateTypeSpecialty
84109CTMDInternal Medicine Physician
MD485264PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oncology Hematology Associates of Northern Illinois, LTD CurrentSince Mar 8, 2025 Accepting new patients
Waukegan Clinic Corp Internal Medicine CurrentSince Mar 8, 2025 Accepting new patients
New York Medical Physician Associates PC CurrentSince Jan 17, 2025 Accepting new patients
Apogee Medical Group of Pennsylvania PC Internal Medicine CurrentSince Jun 1, 2024 Accepting new patients
New York Medical Physician Associates PC Internal Medicine Current Accepting new patients
New York Medical Physician Associates PC CurrentSince Jan 17, 2025 Accepting new patients
Apogee Medical Group of Pennsylvania PC Internal Medicine CurrentSince Jun 1, 2024 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

  • FHIR API: https://api.platform.athenahealth.com/2069/brand/1/csg/29/fhir/r4
  • Direct secure messaging: 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.

Hospital & facility affiliations 6

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": "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

Verify at the official NPI Registry.