Individual provider Active NPI

Imran Khan, OD

  • Optometrist
  • New York, NY
National Provider Identifier
1710769872
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
009789 Issued in NY
Practice address
1503 3Rd Ave
New York, NY 10028-2116
Phone
(917) 244-1265
NPI assigned
Oct 13, 2023
Last updated
Jan 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 27OM00204000 NJ
Optometrist 152W00000X 009789 NY Primary
Optometrist 152W00000X 27OA00736100 NJ

Addresses

Primary practice location

1503 3Rd Ave
New York, NY 10028-2116

Mailing address

1269 E 40TH St
Brooklyn, NY 11210-4958
Phone (917) 244-1265

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250617002801 NY Practitioner - Optometry 5799296646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Manhattan Optometry and Ophthalmic Dispensing PLLCGroup PAC ID 0143542019, 3 clinicians

Practice addresses (Care Compare)

400 W 42ND St
New York, NY 10036-6814
Phone (212) 869-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27OA00736100NJMDOptometrist
27OM00204000NJMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Manhattan Optometry and Ophthalmic Dispensing PLLC Optometrist CurrentSince Mar 30, 2025 Accepting new patients
Manhattan Optometry and Ophthalmic Dispensing PLLC Optometrist PastSince Mar 30, 2025 Accepting new patients

Locations

187 Avenue U
Brooklyn, NY 11223
Phone (718) 373-2020

1503 3rd Ave
New York, NY 10028
Phone (212) 426-1222

400 W 42nd St
New York, NY 10036
Phone (212) 430-2020

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1697155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1710769872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1269 E 40TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112104958",
            "telephone_number": "917-244-1265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 3RD AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100282116",
            "telephone_number": "917-244-1265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "IMRAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-13",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OM00204000",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "009789",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00736100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.