NPIMap

Individual provider Active NPI

Seyyar Ahmad Khan

  • Nephrology Physician
  • Jackson Heights, NY
National Provider Identifier
1831429406
Registry record updated Nov 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
268632 Issued in NY
Practice address
3435 70TH St
Jackson Heights, NY 11372-1055
Phone
(347) 460-4253
Fax
(718) 355-9650
NPI assigned
Jan 5, 2010
Last updated
Nov 21, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 268632 NY Primary

Addresses

Primary practice location

3435 70TH St
Jackson Heights, NY 11372-1055

Mailing address

3435 70TH St
Jackson Heights, NY 11372-1055
Phone (347) 460-4253

Other practice location 1

12507 101st Ave
South Richmond Hill, NY 11419-1411
Phone (347) 460-4253

Other practice location 2

1752 Francis Lewis Blvd
Flushing, NY 11357-3247
Phone (347) 460-4253

Other identifiers 1

IdentifierTypeStateIssuer
74120715700OtherNYFIDELIS CARE

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
I20130703000293 NY Practitioner - Internal MedicinePractitioner - Nephrology 8628218187 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glow Wellness Care Medical PLLCGroup PAC ID 6406392877, 2 clinicians
New York Kidney PhysiciansGroup PAC ID 4284978115, 8 clinicians

Practice addresses (Care Compare)

3027 Jericho Tpke
East Northport, NY 11731-6230
Phone (516) 857-6177

3435 70TH St
Jackson Heights, NY 11372-1055
Phone (718) 651-9700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
268632NYMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Glow Wellness Care Medical PLLC Nephrology CurrentSince Jul 26, 2024 Accepting new patients
Seyyar Khan MD PC Nephrology CurrentSince Jul 8, 2024 Accepting new patients
Jackson Heights Care Center, LLC Past Accepting new patients
The Silvercrest Center for Nursing and Rehabilitation Past Accepting new patients

Locations

3027 Jericho Tpke
East Northport, NY 11731
Phone (516) 665-1476

Networks

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

Interoperability endpoints

  • Direct secure messaging: skhan16380@direct.acumenmd.com

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 6

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": "1262649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542758400000",
    "number": "1831429406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 70TH ST",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113721055",
            "telephone_number": "347-460-4253",
            "fax_number": "718-355-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 70TH ST",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113721055",
            "telephone_number": "347-460-4253",
            "fax_number": "718-355-9650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12507 101st Ave",
            "address_purpose": "LOCATION",
            "city": "South Richmond Hill",
            "state": "NY",
            "postal_code": "114191411",
            "country_code": "US",
            "telephone_number": "347-460-4253",
            "fax_number": "718-355-9650",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1752 Francis Lewis Blvd",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113573247",
            "country_code": "US",
            "telephone_number": "347-460-4253",
            "fax_number": "718-355-9650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAN",
        "first_name": "SEYYAR",
        "middle_name": "AHMAD",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-05",
        "last_updated": "2018-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "268632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS CARE",
            "identifier": "74120715700",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson Heights, NY

Sources for this page

Verify at the official NPI Registry.