Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ananta Khellawan

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1013880475

Ananta Khellawan is a Nurse Practitioner in Bellerose, New York. Graduated from State University of New York at Stony Brook, School of Medicine in 2025, 1 year ago. Practices with Medagent Corp, a 26-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
1
Trained at
State University of New York at Stony Brook, School of Medicine
Licensed in
NY
In the registry since
2025

Practice location Address checks out

24806 87th Ave Ph
Bellerose, NY 11426-2032
Phone: (718) 551-4638
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence F407319 (NY)

Record details

NPI number1013880475
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 23, 2025
Last updated in NPPESSeptember 23, 2025
Certification dateSeptember 23, 2025
Mailing address24806 87th Ave, Bellerose, NY 11426-2032

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolSTATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE
Graduated 2025 (1 years in practice)
Group practice Medagent Corp — 26 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Bellerose