Individual provider Active NPI

Sana Youssef Nejmeh-Khoury, M.D

  • Pediatrics Physician
  • Brooklyn, NY
National Provider Identifier
1770638041
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
225782 Issued in NY
Practice address
47 78TH St
Brooklyn, NY 11209-2911
Phone
(718) 745-2359
Fax
(718) 745-2378
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 225782-1 NY
Pediatrics Physician 208000000X 225782 NY Primary

Addresses

Primary practice location

47 78TH St
Brooklyn, NY 11209-2911

Mailing address

670 92ND St
Brooklyn, NY 11228-3632
Phone (718) 833-7466

Other identifiers 5

IdentifierTypeStateIssuer
7822679OtherNYAETNA NON-HMO
02712178MedicaidNY
5C4328OtherNYHEALTH NET
NY225782-1OtherNY1199SEIU
3818374OtherNYAETNA HMO

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
I20160929000481 NY Practitioner - Pediatric Medicine 5597052902 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
225782-1NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Interfaith Professional Physician Services, P.C. Pediatrics CurrentSince Jul 9, 2016 Accepting new patients

Locations

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

528 Prospect Pl
Brooklyn, NY 11238
Phone (718) 613-6800

Networks

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

Organizations & group practices 1

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1770638041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 92ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112283632",
            "telephone_number": "718-833-7466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 78TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112092911",
            "telephone_number": "718-745-2359",
            "fax_number": "718-745-2378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEJMEH-KHOURY",
        "first_name": "SANA",
        "middle_name": "YOUSSEF",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "225782-1",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "225782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NON-HMO",
            "identifier": "7822679",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02712178",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "5C4328",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1199SEIU",
            "identifier": "NY225782-1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3818374",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.