Individual provider Active NPI

Adam Khayat

  • Surgery Physician
  • Chicago, IL
National Provider Identifier
1700468139
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
125.080880 Issued in IL
Practice address
1620 W Harrison St
Chicago, IL 60612-3801
Phone
(312) 942-5000
NPI assigned
Apr 26, 2021
Last updated
Jun 30, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 125.080880 IL Primary

Addresses

Primary practice location

1620 W Harrison St
Chicago, IL 60612-3801

Mailing address

1620 W Harrison St
Chicago, IL 60612-3801

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adam.khayat@nyulangone.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220915001061 IL Order and Referring Only - General SurgeryPractitioner - General Surgery 9335524164

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125.080880ILMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1700468139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 W HARRISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123801",
            "telephone_number": "312-942-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAYAT",
        "first_name": "ADAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-26",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "125.080880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adam.khayat@nyulangone.org",
            "affiliation": "N",
            "address_1": "260 1st St Apt B6",
            "city": "Mineola",
            "state": "NY",
            "country_code": "US",
            "postal_code": "115012302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.