Active NPI
Eva Takhalova, DO
- Neonatal-Perinatal Medicine Physician
- Boston, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal-Perinatal Medicine Physician
- License
- 309471
- Practice address
- 800 Washington St
Boston, MA 02111-1552 - Phone
- (617) 636-5000
- NPI assigned
- May 25, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 287835 | MA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 309471 | NY | Primary |
Addresses
Primary practice location
800 Washington St
Boston, MA 02111-1552
Mailing address
45 Stuart St Apt 2002
Boston, MA 02116-4765
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) | |
| Direct Messaging Address | evt4002@direct.nyp.org | Direct | |
| FHIR URL | https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/ | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 309471 | NY | MD | Administrator Registered Nurse |
| 287835 | MA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New York University | Current | Accepting new patients | |
| New York University | Pediatrics | Current | Accepting new patients |
| The New York and Presbyterian Hospital | Past | Accepting new patients |
Locations
506 6th St
Brooklyn, NY 11215
Phone (718) 780-3279
506 6th St
Ste B
Brooklyn, NY 11215
Phone (718) 780-3677
222 Station Plz N
Ste 620
Mineola, NY 11501
Phone (516) 663-2450
13303 Jamaica Ave
#13292
Richmond Hill, NY 11418
Phone (718) 291-3276
13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942
Interoperability endpoints
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
- evt4002@direct.nyp.org
- https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
Organizations & group practices 3
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.
-
- Cardiovascular Disease Physician
- Boynton Beach, FL
- NPI 1285826438
NY, Pediatrics
-
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
-
- General Acute Care Hospital
- New York, NY
- NPI 1952332801
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722556800000",
"number": "1346731205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 STUART ST APT 2002",
"city": "BOSTON",
"state": "MA",
"postal_code": "021164765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 WASHINGTON ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021111552",
"telephone_number": "617-636-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAKHALOVA",
"first_name": "EVA",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-25",
"last_updated": "2024-08-02",
"certification_date": "2024-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "287835",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2080N0001X",
"taxonomy_group": "",
"desc": "Pediatrics, Neonatal-Perinatal Medicine",
"state": "NY",
"license": "309471",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "506 6th St",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112153609",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "evt4002@direct.nyp.org",
"affiliation": "N",
"endpointDescription": "Direct Address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Direct Address",
"address_1": "506 6th St",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112153609",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/",
"affiliation": "N",
"endpointDescription": "FHIR",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "FHIR",
"address_1": "506 6th St",
"city": "Brooklyn",
"state": "NY",
"country_code": "US",
"postal_code": "112153609",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.