NPIMap

Organization Active NPI

Tatiana Khrom, M.D., P.C.

  • MOHS-Micrographic Surgery Physician
  • Brooklyn, NY
National Provider Identifier
1184739799
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
227196 Issued in NY
Legal business name
TATIANA KHROM, M.D., P.C.
Practice address
2797 Ocean Pkwy Ste 3
Brooklyn, NY 11235-7868
Phone
(718) 615-4000
Fax
(718) 615-4004
NPI assigned
Aug 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Authorized official

Name
Dr. Tatiana Khrom, M.D.NPI 1457374704
Title
President
Phone
(646) 479-8039

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X 227196 NY
MOHS-Micrographic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0101X 227196 NY Primary
Procedural Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207NS0135X 227196 NY

Addresses

Primary practice location

2797 Ocean Pkwy Ste 3
Brooklyn, NY 11235-7868

Mailing address

2797 Ocean Parkway
3Rd Floor
Brooklyn, NY 11235-7868
Phone (718) 615-4000

Other practice location 1

8421 Bay Pkwy
Brooklyn, NY 11214-3303
Phone (718) 615-4000

Other practice location 2

239 Court St
Brooklyn, NY 11201-6592
Phone (718) 615-4000

Other identifiers 1

IdentifierTypeStateIssuer
02804617MedicaidNY

Other names 1

  • Khrom Dermatology & Aesthetics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061030000436 NY Part B Supplier - Clinic/Group Practice 1557368859 Receives reassigned benefits from 12 practitioners
Practice locations: Brooklyn, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1057500Khrom Dermatology2797 Ocean Parkway, 3Rd Floor, Brooklyn, NY 11235ComplianceOct 4, 2027

National Provider Directory

National Provider Directory

Locations

12462 W Atlantic Blvd
Ste 1
Coral Springs, FL 33071
Phone (954) 688-9677

2797 Ocean Pkwy
Ste 3
Brooklyn, NY 11235
Phone (718) 615-4000

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1184739799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2797 OCEAN PARKWAY",
            "address_2": "3RD FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112357868",
            "telephone_number": "718-615-4000",
            "fax_number": "718-615-4004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2797 OCEAN PKWY STE 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112357868",
            "telephone_number": "718-615-4000",
            "fax_number": "718-615-4004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8421 Bay Pkwy",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112143303",
            "country_code": "US",
            "telephone_number": "718-615-4000",
            "fax_number": "718-615-4004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "239 Court St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112016592",
            "country_code": "US",
            "telephone_number": "718-615-4000",
            "fax_number": "718-615-4004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TATIANA KHROM, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "KHROM",
        "authorized_official_first_name": "TATIANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "646-479-8039",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "NY",
            "license": "227196",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NY",
            "license": "227196",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NY",
            "license": "227196",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02804617",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Khrom Dermatology & Aesthetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.