Individual provider Active NPI

Leonid Khokhlov, MD

  • Student in an Organized Health Care Education/Training Program
  • Cincinnati, OH
National Provider Identifier
1336712108
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
375 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone
(513) 862-1800
NPI assigned
Jul 20, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193400000X SINGLE SPECIALTY GROUP 390200000X Primary

Addresses

Primary practice location

375 Dixmyth Ave
Cincinnati, OH 45220-2475

Mailing address

111 Garfield PL Apt 300
Cincinnati, OH 45202-1926
Phone (513) 885-8974

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address leonid_khokhlov@trihealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210727002090 OH Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6002219177

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1336712108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 GARFIELD PL APT 300",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452021926",
            "telephone_number": "513-885-8974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 DIXMYTH AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452202475",
            "telephone_number": "513-862-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOKHLOV",
        "first_name": "LEONID",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "leonid_khokhlov@trihealth.com",
            "affiliation": "N",
            "address_1": "375 Dixmyth Ave",
            "city": "Cincinnati",
            "state": "OH",
            "country_code": "US",
            "postal_code": "452202475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.