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

Individual provider Pediatrics Physician · NPI 1073788667

Dr. Kashyar Khodabakhsh, MD is a Neurology in New York, New York. Qualified in 2003, 23 years ago. Practices with Four Corners Medical PC, a 2-clinician group and accepts Medicare assignment. Licensed in Michigan and New York.

Years since qualifying
23
Licensed in
MI, NY
In the registry since
2008
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

10 Union Sq E
New York, NY 10003-3314
Phone: (914) 428-0529
Fax: (718) 240-8607
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurology Physician (primary) Taxonomy 2084N0400X · Licence 258356 (NY)
Pediatrics Physician Taxonomy 208000000X · Licence 4301090255 (MI)

Record details

NPI number1073788667
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 24, 2008
Last updated in NPPESJune 27, 2013

Medicare enrollment

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

Medicare specialtyNEUROLOGY
Also practisesPEDIATRIC MEDICINE
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Four Corners Medical Pc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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