Individual provider Active NPI

Tarek R Khater, M.D.,

  • General Practice Physician
  • New York, NY
National Provider Identifier
1720456049
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
128919 Issued in NY
Practice address
229 E 85TH St
672
New York, NY 10028-9600
Phone
(917) 960-0821
Fax
(646) 952-2004
NPI assigned
Sep 2, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 2010966 PTAL CA
Sonography Specialist/Technologist Cardiovascular 246XS1301X CCI: 00093517 NC
Sonography Radiologic Technologist 2471S1302X ARDMS: 176911 MD
General Practice Physician 208D00000X 128919 NY Primary

Addresses

Primary practice location

229 E 85TH St
672
New York, NY 10028-9600

Mailing address

229 E 85TH St
672
New York, NY 10028-9600
Phone (917) 960-0821

Other identifiers 2

IdentifierTypeStateIssuer
128919OtherNYNYC MRC
3517284OtherNYDBA

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
I20250703001623 NY Practitioner - Internal Medicine 3476867540 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2010966 PTALCAMDGeneral Practice Physician
128919NYMDGeneral Practice Physician
CCI: 00093517NCMDSonography Specialist/Technologist
ARDMS: 176911MDMDSonography Radiologic Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medicine Solutions P.C. CurrentSince May 7, 2025 Accepting new patients
Tarek R Khater CurrentSince Jul 1, 2018 Accepting new patients

Locations

6411 Beach Channel Dr
Far Rockaway, NY 11692
Phone (718) 471-7010

275 W Merrick Rd
Freeport, NY 11520
Phone (516) 377-2946

154 Prospect Ave
Plattsburgh, NY 12901
Phone (518) 563-5440

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1720456049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 E 85TH ST",
            "address_2": "672",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100289600",
            "telephone_number": "917-960-0821",
            "fax_number": "646-952-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 E 85TH ST",
            "address_2": "672",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100289600",
            "telephone_number": "917-960-0821",
            "fax_number": "646-952-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHATER",
        "first_name": "TAREK",
        "middle_name": "R",
        "credential": "M.D.,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-02",
        "last_updated": "2026-02-12",
        "certification_date": "2020-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "2010966 PTAL",
            "primary": false
        },
        {
            "code": "246XS1301X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist Cardiovascular, Sonography",
            "state": "NC",
            "license": "CCI: 00093517",
            "primary": false
        },
        {
            "code": "2471S1302X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Sonography",
            "state": "MD",
            "license": "ARDMS: 176911",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "128919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYC MRC",
            "identifier": "128919",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DBA",
            "identifier": "3517284",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.