Individual provider Active NPI

Karishma Karim Khetani, MD

  • Internal Medicine Physician
  • Newark, NJ
National Provider Identifier
1568091445
Registry record updated Jul 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA12097300 Issued in NJ
Practice address
150 Bergen St RM I-248
Newark, NJ 07103-2496
Phone
(973) 972-6056
NPI assigned
Apr 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA12097300 NJ Primary

Addresses

Primary practice location

150 Bergen St RM I-248
Newark, NJ 07103-2496

Mailing address

150 Bergen Street
University Hospital Building / Room I-248
Newark, NJ 07101
Phone (913) 244-8452

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20240626004040 NJ Practitioner - Internal MedicinePractitioner - Pediatric Medicine 3173067501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

140 Bergen St
Newark, NJ 07103-2425
Phone (973) 972-9000

90 Bergen St
Newark, NJ 07103-2425
Phone (973) 972-5004

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Associates of New Jersey Inc Internal Medicine CurrentSince Jul 1, 2024 Accepting new patients
University Hospital Past Accepting new patients
Newark Beth Israel Medical Center Inc Past Accepting new patients

Locations

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

150 Bergen St
Rm I248
Newark, NJ 07103
Phone (973) 972-2449

150 Bergen St
Newark, NJ 07103
Phone (973) 972-6056

90 Bergen St
Newark, NJ 07103
Phone (973) 972-0037

30 Bergen St
#12
Newark, NJ 07107
Phone (973) 972-0037

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 1

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": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722038400000",
    "number": "1568091445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 BERGEN STREET",
            "address_2": "UNIVERSITY HOSPITAL BUILDING / ROOM I-248",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "07101",
            "telephone_number": "913-244-8452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BERGEN ST RM I-248",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032496",
            "telephone_number": "973-972-6056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHETANI",
        "first_name": "KARISHMA",
        "middle_name": "KARIM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2024-07-27",
        "certification_date": "2024-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA12097300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.