Active NPI
Omar Kamaal Khalique, MD
- Cardiovascular Disease Physician
- New York, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 260639-1
- Practice address
- 622 W 168TH St
New York, NY 10032-3720 - Phone
- (212) 342-3616
- Fax
- (212) 342-3640
- NPI assigned
- Mar 11, 2011
- Last updated
- Jun 14, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 260639-1 | NY | Primary |
| Clinical Cardiac Electrophysiology Physician | 207RC0001X | 260639 | NY |
Addresses
Primary practice location
622 W 168TH St
New York, NY 10032-3720
Mailing address
630 W 168TH St
Box 4
New York, NY 10032-3725
Phone (212) 342-3616
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Jefferson Medical College of Thomas Jefferson University, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Port Washington Blvd
Roslyn, NY 11576-1347
Phone (516) 562-6000
2200 Northern Blvd
100C St Francis Diagnostic
Greenvale, NY 11548-1220
Phone (516) 325-7400
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 260639-1 | NY | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CHS Physician Partners, P.C | Cardiovascular Disease | Current | Accepting new patients |
| St. Francis Cardiac Prevention Services PC | Current | Accepting new patients | |
| CHS Physician Partners, PC | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| Columbiadoctors/Newyork-Presbyterianimaging | Current | Accepting new patients | |
| Trustees of Columbia University in the City of New York | Current | Accepting new patients | |
| Trustees Columbia University City Ny Center Interventional Vascular TH | Past | Accepting new patients |
Locations
2460 Mickle Ave
Bronx, NY 10469
Phone (718) 424-3131
2200 Northern Blvd
Greenvale, NY 11548
Phone (516) 325-7310
2200 Northern Blvd
Ste 100C
Greenvale, NY 11548
Phone (516) 325-7400
2200 Northern Blvd
Ste 118
Greenvale, NY 11548
Phone (516) 563-7910
4 Ohio Dr
New Hyde Park, NY 11042
Phone (516) 519-8260
161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559
161 Fort Washington Ave
Fl 5
New York, NY 10032
Phone (212) 305-4000
622 W 168th St
New York, NY 10032
Phone (212) 305-4931
622 W 168th St
#4100
New York, NY 10032
Phone (212) 305-5123
630 W 168th St
#4
New York, NY 10032
Phone (212) 305-6387
1000 N Village Ave
Rockville Ctr, NY 11570
Phone (516) 705-1012
100 Port Washington Blvd
Roslyn, NY 11576
Phone (516) 562-6385
100 Port Washington Blvd
Ste G3
Roslyn, NY 11576
Phone (516) 627-4800
1000 Montauk Hwy
West Islip, NY 11795
Phone (516) 705-2689
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H3359
Interoperability endpoints
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
Organizations & group practices 11
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.
-
dba Cardiac Interventional Group
- Interventional Cardiology Physician
- Fresh Meadows, NY
- NPI 1407089345
-
dba St. Francis Diagnostic
- Diagnostic Radiology Physician
- Melville, NY
- NPI 1376952804
-
- Specialist
- New York, NY
- NPI 1902345986
-
dba Department of Medicine
- Internal Medicine Physician
- New York, NY
- NPI 1437176047
-
dba Columbia Presbyterian Radiologists
- Diagnostic Radiology Physician
- New York, NY
- NPI 1467560854
-
- Surgery Physician
- New York, NY
- NPI 1508266347
-
- Internal Medicine Physician
- Fort Lee, NJ
- NPI 1982993184
NY
-
- Cardiovascular Disease Physician
- Roslyn, NY
- NPI 1164585725
-
- Anesthesiology Physician
- New York, NY
- NPI 1477068971
-
- Internal Medicine Physician
- New York, NY
- NPI 1699289488
-
dba Center Interventional Vascular Therapy
- Interventional Cardiology Physician
- New York, NY
- NPI 1174556823
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- West Islip, NY
- NPI 1902865355
-
dba St. Charles Hospital
- General Acute Care Hospital
- Port Jefferson, NY
- NPI 1164481529
-
- General Acute Care Hospital
- Smithtown, NY
- NPI 1982663423
-
- General Acute Care Hospital
- Roslyn, NY
- NPI 1043279565
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497398400000",
"number": "1629376850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 W 168TH ST",
"address_2": "BOX 4",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100323725",
"telephone_number": "212-342-3616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "622 W 168TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100323720",
"telephone_number": "212-342-3616",
"fax_number": "212-342-3640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHALIQUE",
"first_name": "OMAR",
"middle_name": "KAMAAL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-03-11",
"last_updated": "2017-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "NY",
"license": "260639-1",
"primary": true
},
{
"code": "207RC0001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
"state": "NY",
"license": "260639",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.