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

Mr. Mohammad Ibraheem Khan, MD

Individual provider Gastroenterology Physician · NPI 1659791663

Mr. Mohammad Ibraheem Khan, MD is a Gastroenterology in Stony Brook, New York. Qualified in 2010, 16 years ago. Practices with St Agnes Healthcare Inc, a 269-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
16
Licensed in
NY
In the registry since
2014
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

Stony Brook Ufpc Practice 101 Nicolls Road Hsc T17-060
Stony Brook, NY 11794-6999
Phone: (631) 444-3518
Fax: (631) 444-8886
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gastroenterology Physician (primary) Taxonomy 207RG0100X · Licence 305306 (NY)

Record details

NPI number1659791663
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 17, 2014
Last updated in NPPESJuly 1, 2020
Certification dateJuly 1, 2020
Mailing addressPo Box 1559, Stony Brook, NY 11790-0989

Medicare enrollment

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

Medicare specialtyGASTROENTEROLOGY
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice St Agnes Healthcare Inc — 269 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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