Individual provider Active NPI

Ishita S Kharode, M.D.

  • Pediatric Endocrinology Physician
  • Staten Island, NY
National Provider Identifier
1831533249
Registry record updated Aug 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
285659 Issued in NY
Practice address
800 Castleton Ave
Staten Island, NY 10310-1805
Phone
(718) 818-1512
NPI assigned
Apr 29, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Endocrinology Physician 2080P0205X 285659 NY Primary

Addresses

Primary practice location

800 Castleton Ave
Staten Island, NY 10310-1805

Mailing address

800 Castleton Ave
Staten Island, NY 10310-1805

Other practice location 1

750 E Adams St
Syracuse, NY 13210-2342
Phone (315) 464-5420

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
I20190827003194 NY Practitioner - Pediatric MedicinePractitioner - Endocrinology 2567709686 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
285659NYMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amboy Medical Practice PC CurrentSince Jul 6, 2019 Accepting new patients
Amboy Medical Practice PC CurrentSince Jul 6, 2019 Accepting new patients
Richmond Medical Center Past Accepting new patients

Locations

1366 Victory Blvd
Staten Island, NY 10301
Phone (718) 273-3400

800 Castleton Ave
Staten Island, NY 10310
Phone (718) 354-3344

355 Bard Ave
Staten Island, NY 10310
Phone (718) 818-1380

1487 Richmond Rd
Staten Island, NY 10304
Phone (718) 979-3643

2655 Richmond Ave
Staten Island, NY 10314
Phone (718) 698-6666

1366 Victory Blvd
Ste A
Staten Island, NY 10301
Phone (718) 727-1366

4434 Amboy Rd
Staten Island, NY 10312
Phone (718) 818-1015

Networks

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

Interoperability endpoints

  • Direct secure messaging: ishita.kharode.1@19656.direct.athenahealth.com

Organizations & group practices 3

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": "1367193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1831533249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CASTLETON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 CASTLETON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101805",
            "telephone_number": "718-818-1512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 E Adams St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132102342",
            "country_code": "US",
            "telephone_number": "315-464-5420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHARODE",
        "first_name": "ISHITA",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-29",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "NY",
            "license": "285659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.