Organization Active NPI

Igal Khorshidi, M.D., P.C.

  • Gastroenterology Physician
  • Elmhurst, NY
National Provider Identifier
1871930073
Registry record updated Jan 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
256986 Issued in NY
Legal business name
IGAL KHORSHIDI, M.D., P.C.
Practice address
7911 41St Ave
A108
Elmhurst, NY 11373-1258
Phone
(212) 734-0000
Fax
(646) 661-2795
NPI assigned
May 29, 2013
Last updated
Jan 6, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2015

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

Authorized official

Name
Dr. Igal Khorshidi, M.D.NPI 1659500668
Title
President
Phone
(516) 456-0304

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X 256986 NY Primary

Addresses

Primary practice location

7911 41St Ave
A108
Elmhurst, NY 11373-1258

Mailing address

7911 41St Ave
A108
Elmhurst, NY 11373-1258
Phone (212) 734-0000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140624000091 NY Part B Supplier - Clinic/Group Practice 2163646688 Receives reassigned benefits from 1 practitioner
Practice locations: Elmhurst, NY

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420502400000",
    "number": "1871930073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7911 41ST AVE",
            "address_2": "A108",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731258",
            "telephone_number": "212-734-0000",
            "fax_number": "646-661-2795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7911 41ST AVE",
            "address_2": "A108",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731258",
            "telephone_number": "212-734-0000",
            "fax_number": "646-661-2795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IGAL KHORSHIDI, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-29",
        "last_updated": "2015-01-06",
        "status": "A",
        "authorized_official_last_name": "KHORSHIDI",
        "authorized_official_first_name": "IGAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-456-0304",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "256986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.