Individual provider Active NPI

Kanwal Jehan Ali, PA-C

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1861280869
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
033484 Issued in NY
Practice address
615 Avenue C
Brooklyn, NY 11218-4101
Phone
(201) 654-6397
Fax
(201) 608-9241
NPI assigned
Apr 29, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 033484 NY Primary

Addresses

Primary practice location

615 Avenue C
Brooklyn, NY 11218-4101

Mailing address

PO Box 22239
New York, NY 10087-0001
Phone (201) 654-6397

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260107003704 NY Practitioner - Physician Assistant 9830675040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1389 E 18TH St
Apt 2a
Brooklyn, NY 11230-7522

PO Box
New York, NY 10087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
033484NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ny Med of Brooklyn LLC CurrentSince Nov 1, 2025 Accepting new patients

Locations

765 Nostrand Ave
Bsmt
Brooklyn, NY 11216
Phone (718) 540-8808

765 Nostrand Ave
Brooklyn, NY 11216
Phone (718) 263-3500

765 Nostrand Ave
Lowr
Brooklyn, NY 11216
Phone (718) 263-3500

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": "1745884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785715200000",
    "number": "1861280869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22239",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100870001",
            "telephone_number": "201-654-6397",
            "fax_number": "201-608-9241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 AVENUE C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112184101",
            "telephone_number": "201-654-6397",
            "fax_number": "201-608-9241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALI",
        "first_name": "KANWAL",
        "middle_name": "JEHAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-29",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "033484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.