Active NPI
Kanwal Jehan Ali, PA-C
- Physician Assistant
- Brooklyn, NY
National Provider Identifier
1861280869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 033484
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
| License | State | Type | Specialty |
|---|---|---|---|
| 033484 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ny Med of Brooklyn LLC | Current | 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.
-
- Multi-Specialty Clinic/Center
- Brooklyn, NY
- NPI 1457011140
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.