Individual provider Active NPI

Abdul S. Khan, MD

  • Neurology Physician
  • Latham, NY
National Provider Identifier
1528028578
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
224442 Issued in NY
Practice address
711 Troy Schenectady Rd Ste 207
Latham, NY 12110-2461
Phone
(518) 867-3030
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 224442 NY Primary

Addresses

Primary practice location

711 Troy Schenectady Rd Ste 207
Latham, NY 12110-2461

Mailing address

711 Troy Schenectady Road
Suite 207
Latham, NY 12110-2442
Phone (518) 867-3030

Other identifiers 1

IdentifierTypeStateIssuer
02258244MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Payer.Credentialing@sphp.com Direct

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
I20050426000918 NY Practitioner - Neurology 3870532211 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Peter'S Health Partners Medical Associates, P.C.Group PAC ID 6103061189, 480 clinicians

Practice addresses (Care Compare)

63 Shaker Rd
Suite 201
Albany, NY 12204-1030
Phone (518) 471-3636

Hospital & facility affiliations

  • Samaritan Hospital of Troy, New York Hospital, Troy, NY, CCN 330180
  • St Peter'S Hospital Hospital, Albany, NY, CCN 330057
  • Sunnyview Hospital and Rehabilitation Center Hospital, Schenectady, NY, CCN 330406
  • Albany Medical Center Hospital Hospital, Albany, NY, CCN 330013
  • Ellis Hospital Hospital, Schenectady, NY, CCN 330153

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
224442NYMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Hospital of Troy, New York CurrentSince Jan 1, 2019 Accepting new patients
St. Peter'S Health Partners Medical Associates, P.C. CurrentSince Oct 2, 2017 Accepting new patients
St. Peter'S Health Partners Medical Associates, P.C. CurrentSince Oct 2, 2017 Accepting new patients

Locations

63 Shaker Rd
Ste 201
Albany, NY 12204
Phone (518) 446-1850

1528 Columbia Tpke
Castleton on Hudson, NY 12033
Phone (518) 477-1191

711 Troy Schenectady Rd
Ste 207
Latham, NY 12110
Phone (518) 867-3030

2 Empire Dr
Ste 202
Rensselaer, NY 12144
Phone (518) 286-4990

2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331

2215 Burdett Ave
Troy, NY 12180
Phone (518) 271-3300

147 Hoosick St
Troy, NY 12180
Phone (518) 268-5749

1300 Massachusetts Ave
Troy, NY 12180
Phone (518) 268-5000

Interoperability endpoints

  • Direct secure messaging: akhan834599@direct.trinity-health.org

Organizations & group practices 3

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 9

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1528028578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY ROAD",
            "address_2": "SUITE 207",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102442",
            "telephone_number": "518-867-3030",
            "fax_number": "518-867-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD STE 207",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102461",
            "telephone_number": "518-867-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "ABDUL",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "224442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02258244",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Payer.Credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPH Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "711 Troy Schenectady Rd Ste 207",
            "city": "Latham",
            "state": "NY",
            "country_code": "US",
            "postal_code": "121102461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

Verify at the official NPI Registry.