Active NPI
Mickel L Khlat, DO
- Internal Medicine Physician
- Smithtown, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 228341
- Practice address
- 267 E Main St BLDG a
Smithtown, NY 11787-2850 - Phone
- (631) 758-7003
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 228341 | NY | Primary |
Addresses
Primary practice location
267 E Main St BLDG a
Smithtown, NY 11787-2850
Mailing address
1 Research Rd
Ridge, NY 11961-2701
Phone (631) 751-3000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02666562 | Medicaid | NY |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Geriatric Medicine
- Education
- New York College of Osteo Medicine of New York Institute of Technology, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1500 Route 112
Port Jefferson Station, NY 11776-8054
Phone (631) 751-3000
365 E Main St
Patchogue, NY 11772-3145
Phone (631) 751-3000
48 Route 25a
Smithtown, NY 11787-1431
Phone (631) 751-3000
Hospital & facility affiliations
- Peconic Bay Homehealth Services
- Catholic Home Care
- John T Mather Memorial Hospital of Port Jefferson
- Suny/Stony Brook University Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore Hematology Oncology Associates PC | Current | Accepting new patients | |
| St. Catherine of Siena Medical Center | Current | Accepting new patients | |
| Southwest Suffolk Medical PC | Current | Accepting new patients | |
| Southwest Suffolk Medical, P.C. | Current | Accepting new patients | |
| Qlimg Rochdale Village OB/GYN Office | Internal Medicine | Past | Accepting new patients |
Locations
3016 30th Dr
Long Island City, NY 11102
Phone (718) 728-3376
245 Old Country Rd
Melville, NY 11747
Phone (631) 465-6141
300 Bay Shore Rd
North Babylon, NY 11703
Phone (631) 586-2700
1500 Route 112
Bldg 4
Port Jefferson Station, NY 11776
Phone (631) 574-8354
1 Research Rd
Ridge, NY 11961
640 Hawkins Ave
Ronkonkoma, NY 11779
Phone (631) 737-0100
48 Route 25A
Smithtown, NY 11787
Phone (631) 862-3540
267 E Main St
Bldg A
Smithtown, NY 11787
Phone (631) 724-2000
50 Route 25A
Smithtown, NY 11787
Phone (631) 465-6225
6279 Route 25A
Wading River, NY 11792
Phone (631) 758-7003
1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
Interoperability endpoints
- mkhlat15431@direct-chsli.net
Organizations & group practices 5
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.
-
- Specialist
- Port Jefferson Station, NY
- NPI 1396794574
-
- Surgical Oncology Physician
- Smithtown, NY
- NPI 1104096049
-
- General Acute Care Hospital
- Smithtown, NY
- NPI 1154764819
-
- Family Medicine Physician
- Lindenhurst, NY
- NPI 1770919763
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Riverhead, NY
- NPI 1932155678
-
- General Acute Care Hospital
- Port Jefferson, NY
- NPI 1093718728
-
- Home Health Agency
- Farmingdale, NY
- NPI 1780670711
-
- General Acute Care Hospital
- Southampton, NY
- NPI 1033224704
-
- General Acute Care Hospital
- Southampton, NY
- NPI 1225507114
-
- General Acute Care Hospital
- Greenport, NY
- NPI 1881690691
-
- General Acute Care Hospital
- Stony Brook, NY
- NPI 1972523348
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732060800000",
"number": "1548288954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 RESEARCH RD",
"city": "RIDGE",
"state": "NY",
"postal_code": "119612701",
"telephone_number": "631-751-3000",
"fax_number": "631-751-0506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "267 E MAIN ST BLDG A",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117872850",
"telephone_number": "631-758-7003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHLAT",
"first_name": "MICKEL",
"middle_name": "L",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2024-11-20",
"certification_date": "2024-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "228341",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02666562",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Smithtown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.