NPIMap

Individual provider Active NPI

Nazanine Khairkhah, MD

  • Nephrology Physician
  • Greenwich, CT
National Provider Identifier
1518937622
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
232715 Issued in NY
Practice address
49 Lake Ave Ste 1B
Greenwich, CT 06830-4501
Phone
(203) 869-2304
Fax
(203) 869-2304
NPI assigned
Jan 23, 2006
Last updated
Dec 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 232715 NY Primary

Addresses

Primary practice location

49 Lake Ave Ste 1B
Greenwich, CT 06830-4501

Mailing address

49 Lake Ave
Ste 104
Greenwich, CT 06830-4501
Phone (203) 869-2304

Other identifiers 1

IdentifierTypeStateIssuer
02575919MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071220000656 CT Practitioner - Internal MedicinePractitioner - Nephrology 3971566894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

49 Lake Ave
Suite 104
Greenwich, CT 06830-4519
Phone (203) 869-2304

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.63 of 100Reported as individual
Quality
86.22
Improvement activities
40
Cost
63.81

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
True Care Medical Practice, Inc. Nephrology CurrentSince Dec 5, 2008 Accepting new patients
Montefiore Mount Vernon Hospital Past Accepting new patients
Life Care Nephrology Group L.L.P Nephrology Past Accepting new patients
Montefiore Medical Center Nephrology Past Accepting new patients

Locations

49 Lake Ave
Ste 104
Greenwich, CT 06830
Phone (203) 869-2304

49 Lake Ave
Ste 1B
Greenwich, CT 06830
Phone (203) 869-2304

38 Bulkley Ave
Port Chester, NY 10573
Phone (914) 937-8800

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CGEJBA/Endpoint/CGEJBA
  • Direct secure messaging: nkhairkhah6496@direct.ynhh.org

Organizations & group practices 4

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 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": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1518937622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 LAKE AVE",
            "address_2": "STE 104",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068304501",
            "telephone_number": "203-869-2304",
            "fax_number": "203-869-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 LAKE AVE STE 1B",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068304501",
            "telephone_number": "203-869-2304",
            "fax_number": "203-869-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAIRKHAH",
        "first_name": "NAZANINE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-23",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "232715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02575919",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwich, CT

Sources for this page

Verify at the official NPI Registry.