NPIMap

Organization Active NPI

Forest Hills Gastroenterology P.C.

  • Gastroenterology Physician
  • Forest Hills, NY
National Provider Identifier
1518078047
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
FOREST HILLS GASTROENTEROLOGY P.C.
Practice address
108-40 Queens Blvd
Forest Hills, NY 11375-7056
Phone
(718) 459-8460
NPI assigned
Aug 31, 2006
Last updated
Jun 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2015

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

Authorized official

Name
Dr. Azeem Khan, M.D.NPI 1538183678
Title
President
Phone
(718) 459-8460

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

108-40 Queens Blvd
Forest Hills, NY 11375-7056

Mailing address

108-40 Queens Blvd
Forest Hills, NY 11375
Phone (718) 459-8460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040330001092 NY Part B Supplier - Clinic/Group Practice 7416846860 Receives reassigned benefits from 7 practitioners
Practice locations: Elmhurst, NY; Forest Hills, NY

National Provider Directory

National Provider Directory

Locations

7410 Broadway
Ste 3
Elmhurst, NY 11373
Phone (718) 971-1340

10840 Queens Blvd
Forest Hills, NY 11375
Phone (718) 268-3161

2000 N Village Ave
Ste 20
Rockville Ctr, NY 11570
Phone (516) 536-7007

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434585600000",
    "number": "1518078047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108-40 QUEENS BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "11375",
            "telephone_number": "718-459-8460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108-40 QUEENS BLVD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757056",
            "telephone_number": "718-459-8460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST HILLS GASTROENTEROLOGY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2015-06-18",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "AZEEM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-459-8460",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.