NPIMap

Individual provider Active NPI

Poonam Khullar, M.D.

  • Anatomic Pathology Physician
  • Mineola, NY
National Provider Identifier
1760444798
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
187022 Issued in NY
Practice address
222 Station PLZ N
Suite 606
Mineola, NY 11501-3808
Phone
(516) 663-2468
Fax
(516) 663-8824
NPI assigned
Apr 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 187022 NY Primary

Addresses

Primary practice location

222 Station PLZ N
Suite 606
Mineola, NY 11501-3808

Mailing address

222 Station PLZ N
Suite 606
Mineola, NY 11501-3808
Phone (516) 663-2468

Other identifiers 1

IdentifierTypeStateIssuer
02335555MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080205000180 NY Practitioner - Pathology 3870675432 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

259 1St St
Mineola, NY 11501-3957
Phone (516) 222-8600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

Merit-based Incentive Payment System (MIPS)

Final score
93.07 of 100Reported as apm
Quality
79.77
Promoting interoperability
88.77
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
187022NYMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
North Shore-Lij Medical PC CurrentSince Jul 25, 2013 Accepting new patients
New York University CurrentSince Oct 1, 2018 Accepting new patients
Winthrop Community Medical Affiliates PC Past Accepting new patients
Medical Group of Mineola, PC Past Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1300 Franklin Ave
Ste ML6
Garden City, NY 11530
Phone (516) 353-1900

1300 Franklin Ave
Ste Ul
Garden City, NY 11530
Phone (516) 663-2224

70 Glen St
Ste 106
Glen Cove, NY 11542
Phone (516) 759-5330

340 W Park Ave
Long Beach, NY 11561
Phone (516) 431-5064

222 Station Plz N
Ste 606
Mineola, NY 11501
Phone (516) 663-2450

120 Mineola Blvd
Ste 600
Mineola, NY 11501
Phone (516) 663-4525

259 1st St
Mineola, NY 11501
Phone (516) 576-1820

1991 Marcus Ave
Ste 101
New Hyde Park, NY 11042
Phone (516) 365-3394

300 Community Dr
Plandome, NY 11030

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • 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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1760444798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 STATION PLZ N",
            "address_2": "SUITE 606",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013808",
            "telephone_number": "516-663-2468",
            "fax_number": "516-663-8824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 STATION PLZ N",
            "address_2": "SUITE 606",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013808",
            "telephone_number": "516-663-2468",
            "fax_number": "516-663-8824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHULLAR",
        "first_name": "POONAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "NY",
            "license": "187022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02335555",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

Verify at the official NPI Registry.