Sergey Prokhorov, MD

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

231008 Issued in NY

Practice address

9817 Queens Boulevard
LL2
Rego Park, NY 11374-3336

Phone

(718) 275-5600

Fax

(718) 275-5608

NPI assigned

Mar 2, 2006

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 NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Downtown Bronx Medical Associates PC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bronx, NY
  • NPI 1689618407

  NY

  Medicare reassignment NPD
• Harlem Medical Associates PC

  • General Practice Physician
  • New York, NY
  • NPI 1487957692

  NY

  Medicare reassignment NPD
• Prokhorov'S Pediatrics and Child Neurology PC

  • Pediatrics Physician
  • Rego Park, NY
  • NPI 1104132778

  Neurology With Special Qualifications in Child Neurology, NY

  Medicare reassignment NPD
• Practice Associates,Inc

  • Physician Assistant
  • Morristown, NJ
  • NPI 1699733907
  NPD (past)
• Specialty Care of Practice Associates,PA

  • Specialist
  • Morristown, NJ
  • NPI 1215985908
  NPD (past)

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307664000000",
    "number": "1366419962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9817 QUEENS BOULEVARD",
            "address_2": "LL2",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743336",
            "telephone_number": "718-275-5600",
            "fax_number": "718-275-5608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9817 QUEENS BOULEVARD",
            "address_2": "LL2",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743336",
            "telephone_number": "718-275-5600",
            "fax_number": "718-275-5608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROKHOROV",
        "first_name": "SERGEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2011-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NY",
            "license": "231008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara Priyev, COSMETOLOGIST
• Pro-Health Medical, P.C.
• Professional Health Radiology P.C
• Professional Office Anesthesia, P.C
• Prohealth Compounding Pharmacy Corp
• Prokhorov'S Pediatrics and Child Neurology PC
• Svetlana Prokhorova, M.D.
• Pronounce and Polish LLC
• Provision at New York LLC
• PT for All PC

• All providers in Rego Park, NY
• Neurology with Special Qualifications in Child Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2011; 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.