Djavlon A Khakimov, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

25MD00360400 Issued in NJ

Practice address

255 Route 3 Ste 107
Secaucus, NJ 07094-3857

Phone

(551) 236-5550

NPI assigned

Mar 29, 2018

Sex

Male

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 NJ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

New York College of Podiatric Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Optum Medical Care of New Jersey PCGroup PAC ID 3072650290, 168 clinicians

Holy Name Primary Care and Specialty Associates PCGroup PAC ID 4082847447, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Holy Name Medical Center Hospital, Teaneck, NJ, CCN 310008
• Palisades Medical Center Hospital, North Bergen, NJ, CCN 310003

Merit-based Incentive Payment System (MIPS)

Final score

85.15 of 100Reported as group

Quality

71.59

Promoting interoperability

100

Improvement activities

40

Cost

76.65

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dkhakimov77107@direct.optum.com

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.

• Holy Name Primary Care and Specialty Associates, PC

  • Psychiatry Physician
  • Teaneck, NJ
  • NPI 1104256130
  Medicare reassignment Care Compare group NPD
• Optum Medical Care of New Jersey PC

  • Pediatrics Physician
  • New Hyde Park, NY
  • NPI 1578665048

  NJ

  Medicare reassignment Care Compare group NPD
• Optum Medical Care of New Jersey PC

  • Durable Medical Equipment & Medical Supplies
  • Belleville, NJ
  • NPI 1255050902
  NPD
• A.G. Dikengil, MD, PA

  • Radiology Clinic/Center
  • Lyndhurst, NJ
  • NPI 1205992690
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• HMH Hospitals Corporation

  • General Acute Care Hospital
  • North Bergen, NJ
  • NPI 1730692344
  Care Compare affiliation
• HMH Hospitals Corporation

  • Clinical Medical Laboratory
  • North Bergen, NJ
  • NPI 1952028532

  Hospital

  Care Compare affiliation
• Holy Name Hospital Regional Dialysis Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Teaneck, NJ
  • NPI 1043389349

  Hospital

  Care Compare affiliation
• Holy Name Medical Center Inc.

  • General Acute Care Hospital
  • Teaneck, NJ
  • NPI 1104859131
  Care Compare affiliation

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1285139261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 UNIVERSITY PLZ STE 205",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076016208",
            "telephone_number": "201-833-3599",
            "fax_number": "201-227-6207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 ROUTE 3 STE 107",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070943857",
            "telephone_number": "551-236-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAKIMOV",
        "first_name": "DJAVLON",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-29",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "25MD00360400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryam Kazmi, DO
• Alexa Kearney, LPC
• Kelly Shimabukuro LLC
• Erin M Kelly, DPT
• Ayman Khafagi, MD
• Ghassan Khani, M.D.
• Sonu Khatri
• Tamara Khmelnitsky, FNP
• Lucy Kim
• Kipnis Orthopaedic Rehab of Secaucus LLC

• Foot & Ankle Surgery Podiatrist in Secaucus, NJ
• Providers in Secaucus, NJ by specialty
• Foot & Ankle Surgery Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; 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.
• 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.