Khadija Tul Kubra

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

P115363 Issued in NY

Practice address

6136 170TH St
Fresh Meadows, NY 11365-1900

Phone

(718) 709-0940

NPI assigned

Jun 8, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: khadija.kubra.1@14448.direct.athenahealth.com

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.

• My Medical PC

  • Family Medicine Physician
  • Valley Cottage, NY
  • NPI 1518637891
  NPD

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1891424495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6136 170TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113651900",
            "telephone_number": "718-709-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6136 170TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113651900",
            "telephone_number": "718-709-0940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBRA",
        "first_name": "KHADIJA",
        "middle_name": "TUL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "P115363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriella Pamela Koyenova
• Paul J Kropas, PT
• Debra Kathryn Krowicki, AUD
• Lisa Renee Krupoff
• Jingrui Ku
• Anselma Kuljanic, RD
• Jana Kuo, MD
• Lyudmila Kushmakova, FNP
• Brittney Kwadwo
• Amy Kwan

• Family Medicine Physician in Fresh Meadows, NY
• Providers in Fresh Meadows, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.