Individual provider Active NPI

Kseniya Khmara, M.D.

  • Anesthesiology Physician
  • Stony Brook, NY
National Provider Identifier
1568874782
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME157032 Issued in FL
Practice address
Department of Anesthesiology
Stony Brook University Hospital HSC 4
Stony Brook, NY 11794-8480
Phone
(631) 444-2975
NPI assigned
May 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 64068 CT
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology Physician 207L00000X ME157032 FL Primary

Addresses

Primary practice location

Department of Anesthesiology
Stony Brook University Hospital HSC 4
Stony Brook, NY 11794-8480

Mailing address

15 Perona LN
Staten Island, NY 10308-3323
Phone (646) 239-2075

Other practice location 1

80 Seymour St
Hartford, CT 06102-8000
Phone (860) 545-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210922003241 NY Practitioner - Anesthesiology 0042548026 Reassigns benefits to 2 organizations
I20221006001988 FL Practitioner - Anesthesiology 0042548026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Florida Anesthesia and Pain Treatment PAGroup PAC ID 8426201401, 88 clinicians

Practice addresses (Care Compare)

901 45TH St
Mangonia Park, FL 33407-2413
Phone (561) 844-6300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Florida Anesthesia & Pain Treatment, P.a. Anesthesiology CurrentSince Oct 21, 2022 Accepting new patients
Albany Medical College Anesthesiology CurrentSince Sep 20, 2021 Accepting new patients
Albany Medical College Anesthesiology Current Accepting new patients
Hudson Ambulatory Medical PLLC Anesthesiology CurrentSince Jan 1, 2022 Accepting new patients
Albany Medical College CurrentSince Sep 20, 2021 Accepting new patients
Albany Medical College Anesthesiology CurrentSince Sep 20, 2021 Accepting new patients
Albany Medical College Current Accepting new patients

Locations

5000 W Oakland Park Blvd
Lauderdale Lakes, FL 33313
Phone (866) 747-5834

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

5325 Greenwood Ave
Ste 301
West Palm Beach, FL 33407
Phone (561) 273-4333

111 Town Square Pl
Ste 420
Jersey City, NJ 07310
Phone (201) 258-4700

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

47 New Scotland Ave
#131
Albany, NY 12208
Phone (518) 262-4300

515 Madison Ave
Fl 9
New York, NY 10022
Phone (212) 774-7633

265 Brookview Centre Way
Ste 400
Knoxville, TN 37919
Phone (865) 293-5549

Interoperability endpoints

  • Direct secure messaging: kkhmara50011@connecticutchildrens.direct-ci.com

Organizations & group practices 7

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": "1400716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1568874782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 PERONA LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103083323",
            "telephone_number": "646-239-2075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF ANESTHESIOLOGY",
            "address_2": "STONY BROOK UNIVERSITY HOSPITAL HSC 4",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948480",
            "telephone_number": "631-444-2975"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Seymour St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061028000",
            "country_code": "US",
            "telephone_number": "860-545-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHMARA",
        "first_name": "KSENIYA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-22",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CT",
            "license": "64068",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME157032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.