Individual provider Active NPI

Koshnaf Antar, MD

  • Rheumatology Physician
  • Middletown, NY
National Provider Identifier
1720194152
Registry record updated Aug 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
219104 Issued in NY
Practice address
111 Maltese Dr
Middletown, NY 10940
Phone
(845) 342-4774
Fax
(845) 818-7555
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 219104 NY Primary

Addresses

Primary practice location

111 Maltese Dr
Middletown, NY 10940

Mailing address

111 Maltese Dr
Middletown, NY 10940
Phone (845) 342-4774

Other identifiers 1

IdentifierTypeStateIssuer
02648328MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050510000773 NY Practitioner - Rheumatology 6204730807 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
White Plains Medical Diagnostic Services, PCGroup PAC ID 5395918932, 95 clinicians

Practice addresses (Care Compare)

41 E Post Rd
White Plains, NY 10601-4607
Phone (914) 681-1201

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
219104NYMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Nyack Hospital CurrentSince Dec 22, 2021 Accepting new patients
White Plains Medical Diagnostic Services, PC Rheumatology CurrentSince Oct 1, 2022 Accepting new patients
Montefiore Nyack Hospital CurrentSince Dec 22, 2021 Accepting new patients
Seth H. Lourie MD PC Past Accepting new patients
Access Medical Group,PC Rheumatology PastSince Feb 1, 2007 Accepting new patients

Locations

111 Maltese Dr
Middletown, NY 10940

160 N Midland Ave
Nyack, NY 10960
Phone (845) 348-2000

300 N Middletown Rd
Ste 11
Pearl River, NY 10965
Phone (845) 735-4114

97 Route 303
Tappan, NY 10983
Phone (845) 348-2198

2 Crosfield Ave
West Nyack, NY 10994
Phone (212) 725-8511

41 E Post Rd
White Plains, NY 10601
Phone (914) 681-1201

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217548800000",
    "number": "1720194152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MALTESE DR",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "10940",
            "telephone_number": "845-342-4774",
            "fax_number": "845-818-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MALTESE DR",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "10940",
            "telephone_number": "845-342-4774",
            "fax_number": "845-818-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTAR",
        "first_name": "KOSHNAF",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2008-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NY",
            "license": "219104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02648328",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.