Individual provider Active NPI

Ali Khairat, M.D.

  • Emergency Medicine Physician
  • New York, NY
National Provider Identifier
1619402567
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20975 Issued in NH
Practice address
234 East 149TH Street, 2C2 Room 445a
Department of Emergency Medicine,
New York, NY 10451
Phone
(718) 579-6011
Fax
(718) 579-4822
NPI assigned
Apr 28, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 20975 NH Primary

Addresses

Primary practice location

234 East 149TH Street, 2C2 Room 445a
Department of Emergency Medicine,
New York, NY 10451

Mailing address

234 East 149TH Street, 2C2 Room 445a
Department of Emergency Medicine,
New York, NY 10451
Phone (718) 579-6011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, WA2 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
I20210318001084 NH Practitioner - Emergency Medicine 3779990791 Reassigns benefits to 1 organization
I20241016002031 WA Practitioner - Emergency Medicine 3779990791 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

4205 Kitsap Way
Bremerton, WA 98312-2447
Phone (360) 782-7780

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince May 1, 2025 Accepting new patients
Hospital Medicine Services of NH, LLC CurrentSince Apr 1, 2023 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Northwest Observation Associates PC CurrentSince Oct 15, 2024 Accepting new patients
Northwest Emergency Physicians LLC Emergency Medicine CurrentSince Oct 15, 2024 Accepting new patients
Franciscan Medical Group Emergency Medicine CurrentSince May 1, 2025 Accepting new patients

Locations

1 Parkland Dr
Derry, NH 03038
Phone (603) 421-2220

4205 Kitsap Way
Bremerton, WA 98312
Phone (360) 782-7780

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Organizations & group practices 6

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": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1619402567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 EAST 149TH STREET, 2C2 ROOM 445A",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE,",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10451",
            "telephone_number": "718-579-6011",
            "fax_number": "718-579-4822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 EAST 149TH STREET, 2C2 ROOM 445A",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE,",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10451",
            "telephone_number": "718-579-6011",
            "fax_number": "718-579-4822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAIRAT",
        "first_name": "ALI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-28",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NH",
            "license": "20975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.