Individual provider Active NPI

Rubia Khalak, MD

  • Neonatal-Perinatal Medicine Physician
  • Albany, NY
National Provider Identifier
1841257243
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
194643 Issued in NY
Practice address
315 S Manning Blvd
St. Peter'S Hospital
Albany, NY 12208-1707
Phone
(518) 525-6560
Fax
(518) 525-6555
NPI assigned
Apr 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 194643 NY Primary

Addresses

Primary practice location

315 S Manning Blvd
St. Peter'S Hospital
Albany, NY 12208-1707

Mailing address

PO Box 14890
Albany, NY 12212-4890

Other identifiers 1

IdentifierTypeStateIssuer
01856940MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address payer.credentialing@sphp.com Direct

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
I20070829000583 NY Practitioner - Pediatric Medicine 2769575281 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ellis Hospital CurrentSince Dec 21, 2025 Accepting new patients
Albany Medical College Current Accepting new patients
St. Peter'S Hospital of the City of Albany CurrentSince Jul 1, 2024 Accepting new patients
Albany Medical College Current Accepting new patients
St. Peter'S Hospital of the City of Albany CurrentSince Jul 1, 2024 Accepting new patients
Albany Medical College CurrentSince Apr 1, 2019 Accepting new patients
Albany Medical Center Hospital Past Accepting new patients

Locations

315 S Manning Blvd
Rm 3563C
Albany, NY 12208
Phone (518) 525-6560

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

315 S Manning Blvd
Albany, NY 12208
Phone (518) 525-1852

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

Interoperability endpoints

  • Direct secure messaging: rkhalak3422001@direct.trinity-health.org
  • Direct secure messaging: rkhalak26074@albanymed.direct-ci.com

Organizations & group practices 7

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": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1841257243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14890",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122124890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 S MANNING BLVD",
            "address_2": "ST. PETER'S HOSPITAL",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122081707",
            "telephone_number": "518-525-6560",
            "fax_number": "518-525-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALAK",
        "first_name": "RUBIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "NY",
            "license": "194643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01856940",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "payer.credentialing@sphp.com",
            "affiliation": "N",
            "endpointDescription": "SPHP - Payer Credentialing",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "315 S Manning Blvd",
            "address_2": "St. Peter's Hospital",
            "city": "Albany",
            "state": "NY",
            "country_code": "US",
            "postal_code": "122081707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.