Individual provider Active NPI

Pankaj Khullar, MD

  • Cardiovascular Disease Physician
  • New York, NY
National Provider Identifier
1497035588
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
285526 Issued in NY
Practice address
1111 Amsterdam Ave
New York, NY 10025-1716
Phone
(212) 523-2400
NPI assigned
Aug 22, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Cardiology Physician 207RI0011X 285526 NY
Student in an Organized Health Care Education/Training Program 390200000X
Cardiovascular Disease Physician 207RC0000X 285526 NY Primary

Addresses

Primary practice location

1111 Amsterdam Ave
New York, NY 10025-1716

Mailing address

8718 Bay Pkwy FL 1-2
Brooklyn, NY 11214-5272
Phone (718) 266-0900

Other practice location 1

111 E 210th St
Bronx, NY 10467-2401
Phone (718) 920-4321

Other practice location 2

1111 Amsterdam Ave # Areah
New York, NY 10025-1716
Phone (212) 523-2400

Other practice location 3

1000 10th Ave
New York, NY 10019-1147
Phone (212) 523-2400

Other practice location 4

8718 Bay Pkwy Fl 1-2
Brooklyn, NY 11214-5272
Phone (718) 266-0900

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
I20180326000244 NY Practitioner - Cardiovascular Disease (Cardiology) 9537421961 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sorin Medical PCGroup PAC ID 5193966059, 17 clinicians
Manana Petrov Primary Medical Care, PCGroup PAC ID 3870576150, 3 clinicians

Practice addresses (Care Compare)

1110 Pennsylvania Ave
Suite 7And8
Brooklyn, NY 11207-9003
Phone (718) 257-0900

120 Wall St
Suite 175
New York, NY 10005-3904
Phone (718) 266-0900

150 55TH St
Brooklyn, NY 11220-2508
Phone (718) 266-0900

232 Sherman Ave
New York, NY 10034-2503
Phone (718) 266-0900

353 Ocean Ave
Brooklyn, NY 11226-1326
Phone (718) 940-2100

44 Sherman Ave
New York, NY 10040-1104
Phone (212) 781-1057

55 Palmer Ave
Bronxville, NY 10708-3403
Phone (914) 768-3354

8718 Bay Pkwy
FL 1 2
Brooklyn, NY 11214-5272
Phone (718) 226-0900

Hospital & facility affiliations

  • NYU Langone Hospitals Hospital, New York, NY, CCN 330214

Merit-based Incentive Payment System (MIPS)

Final score
63.27 of 100Reported as individual
Quality
54.94
Promoting interoperability
0
Improvement activities
40
Cost
72.61

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Varicose vein removal81
Leg revascularization (restoring blood flow)211

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
285526NYMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince May 1, 2018 Accepting new patients
Sorin Medical PC Cardiovascular Disease CurrentSince Dec 24, 2017 Accepting new patients
Icahn School of Medicine at Mount Sinai Cardiovascular Disease CurrentSince May 1, 2018 Accepting new patients
Manana Petrov Primary Medical Care, PC CurrentSince Jan 1, 2022 Accepting new patients
Back Kim MD PC Dba Heartvein Nyc Cardiovascular Disease CurrentSince Jan 1, 2021 Accepting new patients
Manana Petrov Primary Medical Care, PC Past Accepting new patients

Locations

55 Meadowlands Pkwy
Secaucus, NJ 07094
Phone (201) 325-6744

8718 Bay Pkwy
Fl 12
Brooklyn, NY 11214

506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279

1110 Pennsylvania Ave
Ste 7
Brooklyn, NY 11207
Phone (718) 498-1111

8718 Bay Pkwy
Ste 1
Brooklyn, NY 11214

150 55th St
Brooklyn, NY 11220
Phone (718) 630-7185

13668 Roosevelt Ave
Unit 2C2D
Flushing, NY 11354
Phone (212) 226-8000

1111 Amsterdam Ave
New York, NY 10025
Phone (212) 523-2309

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

44 Sherman Ave
New York, NY 10040
Phone (212) 781-1057

131 W 35th St
Fl 7
New York, NY 10001
Phone (212) 475-8252

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

5850 Catalpa Ave
Ste 1
Ridgewood, NY 11385

Networks

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

Interoperability endpoints

  • Direct secure messaging: pankaj.khullar.1@8181.direct.athenahealth.com
  • Direct secure messaging: pkhullar764325@nyumc.direct-ci.com

Organizations & group practices 7

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 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": "1313971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1497035588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8718 BAY PKWY FL 1-2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112145272",
            "telephone_number": "718-266-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 AMSTERDAM AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100251716",
            "telephone_number": "212-523-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "718-920-4321",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1111 Amsterdam Ave # Areah",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100251716",
            "country_code": "US",
            "telephone_number": "212-523-2400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 10th Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100191147",
            "country_code": "US",
            "telephone_number": "212-523-2400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8718 Bay Pkwy Fl 1-2",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112145272",
            "country_code": "US",
            "telephone_number": "718-266-0900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHULLAR",
        "first_name": "PANKAJ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-22",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NY",
            "license": "285526",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NY",
            "license": "285526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.