NPIMap

Organization Active NPI

Advanced Medical Concepts PC

  • Pain Medicine (Anesthesiology) Physician
  • Flushing, NY
National Provider Identifier
1356651251
Registry record updated Oct 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
244768 Issued in NY
Legal business name
ADVANCED MEDICAL CONCEPTS PC
Practice address
7112 Main Street
Flushing, NY 11367
Phone
(718) 263-0055
NPI assigned
Oct 14, 2010
Last updated
Oct 14, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2010

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

Authorized official

Name
Daniel Khaimov, MDNPI 1750545307
Title
Owner
Phone
(347) 220-2769

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 244768 NY Primary

Addresses

Primary practice location

7112 Main Street
Flushing, NY 11367

Mailing address

PO Box 670067
Flushing, NY 11367
Phone (347) 220-2769

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101221000747 NY Part B Supplier - Clinic/Group Practice 1557559382 Receives reassigned benefits from 9 practitioners
Practice locations: Flushing, NY; Jamaica, NY

National Provider Directory

National Provider Directory

Locations

7112 Main St
Flushing, NY 11367
Phone (718) 263-0055

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287014400000",
    "number": "1356651251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670067",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11367",
            "telephone_number": "347-220-2769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7112 MAIN STREET",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "11367",
            "telephone_number": "718-263-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MEDICAL CONCEPTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-14",
        "last_updated": "2010-10-14",
        "status": "A",
        "authorized_official_last_name": "KHAIMOV",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-220-2769",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NY",
            "license": "244768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.