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GLOW WELLNESS CARE MEDICAL PLLC
NPI 1245072909
Internal Medicine - Nephrology in East Northport, NY

Active since June 12, 2024
3027 JERICHO TPKE, EAST NORTHPORT, NY 11731(516) 665-1476(516) 620-3773 Get Directions Write a Review

NPPES record last updated: June 12, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Glow Wellness Care Medical Pllc NPPES

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

GLOW WELLNESS CARE MEDICAL PLLC (NPI 1245072909) is a healthcare organization registered as a nephrology in East Northport, New York and active in the NPI registry since June 2024. The organization lists Shahab Khan, Md, as its authorized official.

NPPES Registry Identity

NPI1245072909
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameGLOW WELLNESS CARE MEDICAL PLLC
Location Address3027 JERICHO TPKEEast Northport, NY 11731-6230
Mailing Address3027 Jericho TpkeEast Northport, NY 11731-6230 · (516) 665-1476 · Fax (516) 620-3773
Phone(516) 665-1476
Fax(516) 620-3773
Organization SubpartNo
Authorized OfficialShahab KhanMd · (347) 476-7399
Enumeration DateJune 12, 2024
NPPES CertifiedJune 12, 2024
✔ NPI 1245072909 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
3027 JERICHO TPKE, East Northport, NY 11731
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Glow Wellness Care Medical Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Glow Wellness Care Medical PLLC, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

Shahab Khan, M.D.
Internal Medicine
NPI 1962812552
3 VERMONT DR
New Hyde Park, NY 11042
(516) 622-6020
✔ PECOS✔ Accepts Medicare20 mi
Seyyar Khan
Internal Medicine
NPI 1831429406
3435 70TH ST
Jackson Heights, NY 11372
(347) 460-4253
✔ PECOS✔ Accepts Medicare31 mi

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

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 Glow Wellness Care Medical PLLC's NPI number?

The NPI number for Glow Wellness Care Medical PLLC is 1245072909. It was assigned to this organization in the NPPES registry on June 12, 2024.

Where is Glow Wellness Care Medical PLLC located?

Glow Wellness Care Medical PLLC is located at 3027 Jericho Tpke, East Northport, NY 11731. The listed phone number is (516) 665-1476.

What is Glow Wellness Care Medical PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Glow Wellness Care Medical PLLC enrolled in Medicare?

Yes. Glow Wellness Care Medical PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Glow Wellness Care Medical PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Internal Medicine, reassign their Medicare billing to Glow Wellness Care Medical PLLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Glow Wellness Care Medical PLLC was last updated on June 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.