NPIMap

Individual provider Active NPI

Vijay Khatiwala, M.D.

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1831160589
Registry record updated Jul 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
193352 Issued in NY
Practice address
640 E 233Rd St
Bronx, NY 10466-2802
Phone
(718) 325-3500
Fax
(718) 325-4655
NPI assigned
Jan 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 193352 NY Primary

Addresses

Primary practice location

640 E 233Rd St
Bronx, NY 10466-2802

Mailing address

640 E 233Rd St
Bronx, NY 10466-2802
Phone (718) 325-3500

Other identifiers 1

IdentifierTypeStateIssuer
01424051MedicaidNY

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
I20080715000598 NY Practitioner - Internal Medicine 6103999719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

640 E 233Rd St
Bronx, NY 10466-2802
Phone (718) 325-1420

Hospital & facility affiliations

  • Montefiore Medical Center Hospital, Bronx, NY, CCN 330059
  • Laconia Nursing Home Nursing home, Bronx, NY, CCN 335388
  • Regeis Care Center Nursing home, Bronx, NY, CCN 335019
  • Wayne Center For Nursing & Rehabilitation Nursing home, Bronx, NY, CCN 335495

Merit-based Incentive Payment System (MIPS)

Final score
19.01 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
63.37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
193352NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ritvij Medical Care PC CurrentSince Nov 1, 2009 Accepting new patients
Total Medical Care, PC CurrentSince Nov 1, 2009 Accepting new patients
McLean Heights Medical Professionals PC PastSince Aug 1, 2024 Accepting new patients
Laconia Nursing Home Inc. Past Accepting new patients
Guido Volcovici PC Past Accepting new patients
Regeis Care Center Past Accepting new patients
Montefiore Medical Center Past Accepting new patients
Wayne Center for Nursing and Rehabilitation Past Accepting new patients

Locations

640 E 233rd St
Bronx, NY 10466
Phone (718) 325-1420

Networks

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

Interoperability endpoints

  • Direct secure messaging: vkhatiwala@mipa.bronxrhiodirect.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Laconia Nursing Home Inc.Bronx, NY, CCN 335388 Skilled nursing facility Operational/Managerial Control
Managing Control - Governing Body
Adp of the SNF		 Dec 1, 1992
Mar 15, 2020
Mar 15, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

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 3

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": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1831160589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 E 233RD ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104662802",
            "telephone_number": "718-325-3500",
            "fax_number": "718-325-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 E 233RD ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104662802",
            "telephone_number": "718-325-3500",
            "fax_number": "718-325-4655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHATIWALA",
        "first_name": "VIJAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-31",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "193352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01424051",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.