Roza Khalilova, R-PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

009485 Issued in NY

Practice address

1220 Avenue P
Brooklyn, NY 11229-1009

Phone

(718) 376-1004

Fax

(718) 376-1150

NPI assigned

Jan 8, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nyc Medical and Neurodiagnostic PC

  • Neurology Physician
  • Rego Park, NY
  • NPI 1669407185
  Medicare reassignment

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

{
    "created_epoch": "1262908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262908800000",
    "number": "1194055491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11155 77TH AVE",
            "address_2": "APT# 1J",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757035",
            "telephone_number": "718-575-8702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 AVENUE P",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291009",
            "telephone_number": "718-376-1004",
            "fax_number": "718-376-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALILOVA",
        "first_name": "ROZA",
        "credential": "R-PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-08",
        "last_updated": "2010-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "009485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farah Khalili
• Merav Khalili
• Narges Khalili
• Shella Khalili
• Tural Khalilov
• Alexander Khalimovskiy
• Saira C. Khalique
• Natallia Khalpukova
• Vanna Kham, NP, RN
• Simone Khamis, MSED

• Physician Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.