Individual provider Active NPI

Marufa Khatun

  • Internal Medicine Physician
  • Flushing, NY
National Provider Identifier
1962812248
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
285757 Issued in NY
Practice address
14015 Sanford Ave
Flushing, NY 11355-2686
Phone
(718) 670-6400
NPI assigned
May 7, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 285757 NY Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

14015 Sanford Ave
Flushing, NY 11355-2686

Mailing address

441 9TH Ave
New York, NY 10001-1623

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
I20170306002759 NY Practitioner - Internal Medicine 9436433653 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interfaith Professional Physician Services PCGroup PAC ID 9931378171, 383 clinicians

Practice addresses (Care Compare)

1545 Atlantic Ave
Brooklyn, NY 11213-1122
Phone (718) 613-4000

8823 178TH St
Jamaica, NY 11432-4639
Phone (718) 558-5047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
285757NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Kingsbrook Medical Associates PC CurrentSince May 3, 2017 Accepting new patients
Patient Priority Medical Care, P. C. Internal Medicine CurrentSince Jun 4, 2020 Accepting new patients
Interfaith Professional Physician Services, P.C. Internal Medicine CurrentSince Jun 1, 2024 Accepting new patients
Kingsbrook Medical Associates, PC CurrentSince May 3, 2017 Accepting new patients

Locations

585 Schenectady Ave
Brooklyn, NY 11203
Phone (718) 604-0461

1110 Eastern Pkwy
Brooklyn, NY 11213
Phone (718) 735-1900

1110 Eastern Pkwy
Pier Toussaint
Brooklyn, NY 11213
Phone (718) 735-1900

1545 Atlantic Ave
Brooklyn, NY 11213
Phone (718) 613-4175

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Organizations & group practices 4

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": "1399420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476748800000",
    "number": "1962812248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 9TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100011623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14015 SANFORD AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113552686",
            "telephone_number": "718-670-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHATUN",
        "first_name": "MARUFA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-07",
        "last_updated": "2016-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "285757",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.