Svetlana Prokhorova, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

223288 Issued in NY

Practice address

9817 Queens Boulevard
LL2
Rego Park, NY 11374-3336

Phone

(718) 275-5600

Fax

(718) 275-5608

NPI assigned

Aug 8, 2006

Last updated

Jun 1, 2011By the provider in NPPES

Sex

Female

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

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Prokhorov's Pediatrics and Child Neurology PC

  • Pediatrics Physician
  • Rego Park, NY
  • NPI 1104132778
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306886400000",
    "number": "1396754107",
    "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": "PROKHOROVA",
        "first_name": "SVETLANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2011-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "223288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Professional Health Radiology P.C
• Professional Office Anesthesia, P.C
• Prohealth Compounding Pharmacy Corp
• Sergey Prokhorov, MD
• Prokhorov's Pediatrics and Child Neurology PC
• Pronounce and Polish LLC
• Provision at New York LLC
• PT for All PC
• PT Rehabilitation PC
• Cynthia M. Purcell, LMHC

• Pediatrics Physician in Rego Park, NY
• Providers in Rego Park, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.