Moazzam Khan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

345352 Issued in NY

Practice address

179 N Belle Mead Rd Ste 3
East Setauket, NY 11733-3528

Phone

(631) 751-3322

Fax

(631) 850-3473

NPI assigned

Mar 27, 2023

Last updated

Sep 20, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• Direct secure messaging: mkhan196501@direct-guthrie.org

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.

• CHS Physician Partners, P.C

  • Cardiovascular Disease Physician
  • Roslyn, NY
  • NPI 1164585725
  NPD (past)

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789862400000",
    "number": "1710680756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 WILLOWOOD LN",
            "city": "CORAM",
            "state": "NY",
            "postal_code": "117271130",
            "telephone_number": "631-846-8900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 N BELLE MEAD RD STE 3",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117333528",
            "telephone_number": "631-751-3322",
            "fax_number": "631-850-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "MOAZZAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-27",
        "last_updated": "2026-09-20",
        "certification_date": "2026-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "345352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rita Marie Kelly, NP
• Jennifer Lynn Keluskar
• Veronica Dawn Keppeler, CCC-SLP
• Howard Adam Keschner, MD
• Fazel A Khan, M.D.
• Mohammed Salim Khan, RPH
• Asim S Khokhar, M.D.
• Tammie Kienzle
• Haksoo Kim, NURSE PRACTITIONER
• Sung Kwang Kim

• Family Medicine Physician in East Setauket, NY
• Providers in East Setauket, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.