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MD GULAM MUKTADIR KHAN DO
NPI 1114667409
Student in an Organized Health Care Education/Training Program in Jamaica, NY

Active since April 01, 2022PECOS Enrolled
8268 164TH ST RM N705, JAMAICA, NY 11432(718) 883-4583(718) 883-6197 Get Directions Write a Review

NPPES record last updated: April 1, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Md Gulam Muktadir Khan Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MD GULAM MUKTADIR KHAN DO (NPI 1114667409) is an individual student in an organized health care education/training program in Jamaica, New York and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114667409
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameMD GULAM MUKTADIR KHANCredential: DO
Location Address8268 164TH ST RM N705Jamaica, NY 11432-1104
Mailing Address8268 164th St Rm N705Jamaica, NY 11432-1104 · (718) 883-4583 · Fax (718) 883-6197
Phone(718) 883-4583
Fax(718) 883-6197
Sole ProprietorNo
Enumeration DateApril 1, 2022
NPPES CertifiedApril 1, 2022
✔ NPI 1114667409 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
8268 164TH ST RM N705, Jamaica, NY 11432
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Md Gulam Muktadir Khan Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHARMIN SULTANA MD,DO
Student in an Organized Health Care Education/Training Program
8268 164TH ST RM N705
JAMAICA, NY 11432
Queens County (718) 883-4583
ANGELA TAI
Student in an Organized Health Care Education/Training Program
8268 164TH ST RM N705
JAMAICA, NY 11432
Queens County (718) 883-4583

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Md Gulam Khan's NPI number?

The NPI number for Md Gulam Khan is 1114667409. It was assigned to this individual provider in the NPPES registry on April 1, 2022.

Where is Md Gulam Khan located?

Md Gulam Khan practices at 8268 164th St Rm N705, Jamaica, NY 11432. The listed phone number is (718) 883-4583.

What is Md Gulam Khan's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Md Gulam Khan enrolled in Medicare?

Yes. Md Gulam Khan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Md Gulam Khan was last updated on April 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.