RENAT KHASANOV MSN, PMHNP-BC, RN
NPI 1174251318
Nurse Practitioner - Psychiatric/Mental Health in Glen Oaks, NY

Q: What is Renat Khasanov's NPI number?

The NPI number for Renat Khasanov is 1174251318. It was assigned to this individual provider in the NPPES registry on August 14, 2022.

Q: What is Renat Khasanov's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Renat Khasanov was last updated on September 23, 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.

Active since August 14, 2022PECOS Enrolled

75-59 263RD STREET, GLEN OAKS, NY 11004(718) 470-5750 Get Directions Write a Review

NPPES record last updated: September 23, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 23, 2022, Aug 14, 2022 (2 updates tracked since 2022).

On this page

About Renat Khasanov Msn, Pmhnp-bc, Rn NPPES

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

RENAT KHASANOV MSN, PMHNP-BC, RN (NPI 1174251318) is an individual psychiatric/mental health provider in Glen Oaks, New York, licensed in New York (404349) and active in the NPI registry since August 2022. He is enrolled in Medicare PECOS and maintains a secondary practice location in Brooklyn.

NPPES Registry Identity

NPI1174251318

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NameRENAT KHASANOVCredential: MSN, PMHNP-BC, RN

Location Address75-59 263RD STREETGlen Oaks, NY 11004-1100

Mailing Address2266 Bath Ave # 3010Brooklyn, NY 11214-5714 · (917) 969-6012

Phone(718) 470-5750

Sole ProprietorYes

Enumeration DateAugust 14, 2022

Last NPPES UpdateSeptember 23, 20222 updates tracked since enumeration

NPPES CertifiedSeptember 23, 2022

✔ NPI 1174251318 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in NY · 404349

75-59 263RD STREET, Glen Oaks, NY 11004

Open in Google Maps ↗

Secondary Practice Location 1

Location 1451 Clarkson AveBrooklyn, NY 11203-2054 · Phone (917) 969-6012

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Renat Khasanov Msn, Pmhnp-bc, Rn 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.

Medicare Billing Reassignment

Medicare enrollment records show Renat Khasanov reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

North Shore - Lij Medical PC

0.1 mi

Internal Medicine

270-05 76TH AVE
New Hyde Park, NY 11040

Reassigned Medicare billing, New York enrollment
9,353 clinicians in this Medicare group

NPI 1790043479 (516) 465-8089

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11004 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$104.17 typical visit price

range $67.00 – $201.98

Typical copayment $26.04 (range $16.75 – $50.49)

Most-billed visit code 99203

Established Patient

$116.96 typical visit price

range $21.62 – $163.52

Typical copayment $29.24 (range $5.40 – $40.88)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

JENNIFER RAHMAN M.D.

Psychiatry & Neurology (Child & Adolescent Psychiatry)

75-59 263RD STREET, ROOM K219
GLEN OAKS, NY 11004

Queens County (718) 470-4032

SNEHA RAJAN BRAY MD

Student in an Organized Health Care Education/Training Program

75-59 263RD STREET
GLEN OAKS, NY 11004

Queens County (718) 470-8005

MITA KALE MD

Student in an Organized Health Care Education/Training Program

75-59 263RD STREET
GLEN OAKS, NY 11004

Queens County (718) 470-8005

EMILY KLASS PHD

Psychologist (Clinical Child & Adolescent)

75-59 263RD STREET, THE ZUCKER HILLSIDE HOSPITAL
GLEN OAKS, NY 11004

Queens County (718) 470-4707

MITCHELL SHAPIRO PSYD

Psychologist

75-59 263RD STREET, ZUCKER HILLSIDE HOSPITAL & DIV. OF PSYCHOLOGY
GLEN OAKS, NY 11004

Queens County (718) 470-8390

JOHN KANE

Psychiatry & Neurology (Psychiatry)

75-59 263RD STREET, THE ZUCKER HILLSIDE HOSPITAL -DEPT OF PSYCHIATRY
GLEN OAKS, NY 11004

Queens County (718) 470-8141

JENNIFER LYNN ORSOMARSO LCSW

Social Worker (Clinical)

75-59 263RD STREET, ZUCKER HILLSIDE HOSPITAL
GLEN OAKS, NY 11004

Queens County (718) 470-8540

MR. KENNETH F. SOKOL R.PH.

Pharmacist

75-59 263RD STREET, ATTN: PHARMACY DEPT.
GLEN OAKS, NY 11004

Queens County (718) 470-8321

RUSHALI KOTHARI MD

Student in an Organized Health Care Education/Training Program

75-59 263RD STREET
GLEN OAKS, NY 11004

Queens County (718) 470-8005

DR. JAGDEESH K DHALIWAL MD

Student in an Organized Health Care Education/Training Program

75-59 263RD STREET
GLEN OAKS, NY 11004

Queens County (718) 470-8005

MITCHELL SHUWALL PHD

Psychologist

75-59 263RD STREET, THE ZUCKER HILLSIDE HOSPITAL-ADMINISTRATION
GLEN OAKS, NY 11004

Queens County (718) 470-8295

LEONARD SARAGNESE NPP

Nurse Practitioner (Psychiatric/Mental Health)

75-59 263RD STREET
GLEN OAKS, NY 11004

Queens County (718) 470-8495

NICHOLAS DEAN FRIED

Student in an Organized Health Care Education/Training Program

75-59 263RD STREET
GLEN OAKS, NY 11004

Queens County (718) 470-8005

DR. MATTHEW FRANCIS STEINHAUER PHD

Psychologist

75-59 263RD STREET, ACP
GLEN OAKS, NY 11004

Queens County (718) 470-8060

DR. LOGAN TUMINELLI PHD

Psychologist (Clinical)

75-59 263RD STREET, LEON LOWENSTEIN, OFFICE #225
GLEN OAKS, NY 11004

Queens County (516) 241-8816

JUDITH JAEGER PHD

Psychologist

75-59 263RD STREET, THE ZUCKER HILLSIDE HOSPITAL-PSYCH REHAB
GLEN OAKS, NY 11004

Queens County (718) 470-8342

SYDNEY BOATENG DO, MS

Student in an Organized Health Care Education/Training Program

75-59 263RD STREET
GLEN OAKS, NY 11004

Queens County (718) 470-8005

MS. SARAH JULIA MARTELL MD

Student in an Organized Health Care Education/Training Program

75-59 263RD STREET
GLEN OAKS, NY 11004

Queens County (718) 470-8005

SALIMA JIWANI

Psychiatry & Neurology (Psychiatry)

75-59 263RD STREET
GLEN OAKS, NY 11004

Queens County (718) 470-8140

FRANCESCA IACONO MD

Student in an Organized Health Care Education/Training Program

75-59 263RD STREET
GLEN OAKS, NY 11004

Queens County (718) 470-8100

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 Renat Khasanov's NPI number?

The NPI number for Renat Khasanov is 1174251318. It was assigned to this individual provider in the NPPES registry on August 14, 2022.

Where is Renat Khasanov located?

Renat Khasanov practices at 75-59 263rd Street, Glen Oaks, NY 11004. The listed phone number is (718) 470-5750.

What is Renat Khasanov's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Renat Khasanov enrolled in Medicare?

Yes. Renat Khasanov is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Renat Khasanov's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Renat Khasanov reassigns Medicare benefits to North Shore - Lij Medical PC (New Hyde Park, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Renat Khasanov's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Renat Khasanov was last updated on September 23, 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.