Active NPI
Krishna Prasad Khanal, MBBS MD CAQSM FAAFP
- Family Medicine Physician
- Montrose, NY
National Provider Identifier
1679708234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- S3832
- Practice address
- 2094 Albany Post Rd
Building # 3
Montrose, NY 10548-1454 - Phone
- (914) 737-4400
- Fax
- (845) 452-6516
- NPI assigned
- May 26, 2009
- 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 39700 | IA | |
| Sports Medicine (Family Medicine) Physician | 207QS0010X | 275691 | NY | |
| Sports Medicine (Family Medicine) Physician | 207QS0010X | A 121654 | CA | |
| Sports Medicine (Family Medicine) Physician | 207QS0010X | 036.130459 | IL | |
| Sports Medicine (Family Medicine) Physician | 207QS0010X | S3832 | TX | |
| Family Medicine Physician | 207Q00000X | S3832 | TX | Primary |
Addresses
Primary practice location
2094 Albany Post Rd
Building # 3
Montrose, NY 10548-1454
Mailing address
1901 Veteran Memorial Dr
Building # 163
Temple, TX 76504
Phone (800) 423-2111
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S3832 | TX | MD | Family Medicine Physician |
| A 121654 | CA | MD | Sports Medicine (Family Medicine) Physician |
| 036.130459 | IL | MD | Sports Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Physician Services of New York, P.C. | Current | Accepting new patients | |
| Eastern Iowa Health Center | Past | Accepting new patients | |
| Eastern Iowa Health Center | Family Medicine | Past | Accepting new patients |
Locations
2209 Genesee St
Utica, NY 13501
Phone (315) 798-8100
Organizations & group practices 3
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.
-
- Emergency Medicine Physician
- Poughkeepsie, NY
- NPI 1093759847
-
dba Eastern Iowa Health Center Pharmacy
- Community/Retail Pharmacy
- Cedar Rapids, IA
- NPI 1346048675
-
- Family Medicine Physician
- Cedar Rapids, IA
- NPI 1578753703
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1243296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591228800000",
"number": "1679708234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1901 VETERAN MEMORIAL DR",
"address_2": "BUILDING # 163",
"city": "TEMPLE",
"state": "TX",
"postal_code": "76504",
"telephone_number": "800-423-2111",
"fax_number": "254-743-0135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2094 ALBANY POST RD",
"address_2": "BUILDING # 3",
"city": "MONTROSE",
"state": "NY",
"postal_code": "105481454",
"telephone_number": "914-737-4400",
"fax_number": "845-452-6516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHANAL",
"first_name": "KRISHNA",
"middle_name": "PRASAD",
"name_prefix": "Dr.",
"credential": "MBBS MD CAQSM FAAFP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-05-26",
"last_updated": "2020-06-04",
"certification_date": "2020-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "39700",
"primary": false
},
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "NY",
"license": "275691",
"primary": false
},
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "CA",
"license": "A 121654",
"primary": false
},
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "IL",
"license": "036.130459",
"primary": false
},
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "TX",
"license": "S3832",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "S3832",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Montrose, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.