Individual provider Active NPI

Mahendranauth Sohan, M.D.

  • Obstetrics & Gynecology Physician
  • Ozone Park, NY
National Provider Identifier
1568545168
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
196678 Issued in NY
Practice address
10612 Liberty Ave
Ozone Park, NY 11417-1811
Phone
(718) 322-1188
Fax
(718) 323-2347
NPI assigned
Oct 24, 2006
Last updated
Jan 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 196678 NY Primary

Addresses

Primary practice location

10612 Liberty Ave
Ozone Park, NY 11417-1811

Mailing address

10612 Liberty Ave
Ozone Park, NY 11417-1811
Phone (718) 322-1188

Other identifiers 1

IdentifierTypeStateIssuer
01517959MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Roosevelt Hospital Center Past Accepting new patients
Brooklyn Womens Pavilion LLC PastSince Jan 14, 2024 Accepting new patients

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1568545168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10612 LIBERTY AVE",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114171811",
            "telephone_number": "718-322-1188",
            "fax_number": "718-323-2347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10612 LIBERTY AVE",
            "city": "OZONE PARK",
            "state": "NY",
            "postal_code": "114171811",
            "telephone_number": "718-322-1188",
            "fax_number": "718-323-2347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOHAN",
        "first_name": "MAHENDRANAUTH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "196678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01517959",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ozone Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.