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Khadija Daniels

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

Based on the most recent information from CMS, provider Khadija Daniels is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 9:43 AM.

Profile Details

Provider ID
1336642883
Provider Type
Individual
Full Name
Daniels, Khadija
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
3/12/2018
Last Updated
12/12/2025

Contact Information

Practice Location

150 55th St, Brooklyn, NY 11220-2508

(718) 630-7000

Unlisted Fax

Mailing Location

6201 Greenleigh Ave, Middle River, MD 21220-2004

(410) 933-0000

(410) 500-4266

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License C0006705 Maryland
Code 363A00000X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer

Khadija Daniels

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Badrian, Solomon

Cohen, Osnat

Dixon, Jeanette O

Kwong, Jennifer

Lempert, Irina

Rondon, Stanley Abraham

Tarasova, Vera

Gangadyal, Kevin Mike

Tong, Thao Phuong

Lin, Anita