NPIMap

Individual provider Active NPI

Larisa Khesina, M.D.

  • Internal Medicine Physician
  • Flushing, NY
National Provider Identifier
1609825736
Registry record updated Dec 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
203378 Issued in NY
Practice address
15034 Union Tpke
Flushing, NY 11367-3928
Phone
(718) 380-0011
Fax
(718) 820-0841
NPI assigned
May 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2013

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 203378 NY Primary

Addresses

Primary practice location

15034 Union Tpke
Flushing, NY 11367-3928

Mailing address

15034 Union Tpke
Flushing, NY 11367-3928
Phone (718) 380-0011

Other identifiers 1

IdentifierTypeStateIssuer
01676517MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060828000136 NY Practitioner - Internal Medicine 4880698224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

15034 Union Tpke
Flushing, NY 11367-3928
Phone (718) 380-0011

18 Rockrose PL
Forest Hills, NY 11375-6053

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
203378NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Union Tpke Medical PC CurrentSince Oct 30, 2011 Accepting new patients

Locations

15034 Union Tpke
Flushing, NY 11367
Phone (718) 380-0011

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IDJHAA/Endpoint/IDJHAA

Organizations & group practices 1

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387238400000",
    "number": "1609825736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15034 UNION TPKE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673928",
            "telephone_number": "718-380-0011",
            "fax_number": "718-820-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15034 UNION TPKE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113673928",
            "telephone_number": "718-380-0011",
            "fax_number": "718-820-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHESINA",
        "first_name": "LARISA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2013-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "203378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01676517",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.