Individual provider Active NPI

Ilana Khaimova, SI

  • Specialist
  • Forest Hills, NY
National Provider Identifier
1114805892
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
10537 64TH Ave Apt 6B
Forest Hills, NY 11375-1639
Phone
(862) 772-8246
NPI assigned
Aug 22, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

10537 64TH Ave Apt 6B
Forest Hills, NY 11375-1639

Mailing address

10537 64TH Ave Apt 6B
Forest Hills, NY 11375-1639
Phone (862) 772-8246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1755820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1114805892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10537 64TH AVE APT 6B",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751639",
            "telephone_number": "862-772-8246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10537 64TH AVE APT 6B",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751639",
            "telephone_number": "862-772-8246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAIMOVA",
        "first_name": "ILANA",
        "credential": "SI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-22",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.