Ishtiaque A Khan

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

P117921 Issued in NY

Practice address

6136 170TH St Apt M4
Fresh Meadows, NY 11365-1957

Phone

(718) 709-0940

Fax

(516) 441-6768

NPI assigned

Nov 15, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1668470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1518675933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6136 170TH ST APT M4",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113651957",
            "telephone_number": "516-794-7200",
            "fax_number": "516-441-6768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6136 170TH ST APT M4",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113651957",
            "telephone_number": "718-709-0940",
            "fax_number": "516-441-6768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "ISHTIAQUE",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-15",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "P117921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Ariel Khafi, DDS
• Daniel Khaimov, M.D.
• Yuriy Khaimov, P.T
• Tasadaq Khan Khakwani, D.D.S
• Ulyana Khaldarov, MD
• Minakshi Khanna, PA
• Sarita Khatri, MD
• Mosammat Shahanara Khatun, RN
• Babita Khemai, M.A., CCC-SLP, TSHH
• Margarita Kheyfets

• Internal Medicine Physician in Fresh Meadows, NY
• Providers in Fresh Meadows, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.

Verify at the official NPI Registry.