NPIMap

Individual provider Active NPI

Arkadiy Takhalov, MD

  • Pediatrics Physician
  • Forest Hills, NY
National Provider Identifier
1396842316
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
221398 Issued in NY
Practice address
11206 71St Rd
Forest Hills, NY 11375-4643
Phone
(718) 520-8585
Fax
(718) 520-8688
NPI assigned
Sep 20, 2006
Last updated
Sep 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 221398 NY Primary

Addresses

Primary practice location

11206 71St Rd
Forest Hills, NY 11375-4643

Mailing address

11220 71St Rd
Forest Hills, NY 11375-4643
Phone (718) 520-7776

Other identifiers 1

IdentifierTypeStateIssuer
02169102MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. T's Pediatrics PLLC CurrentSince Feb 22, 2011 Accepting new patients
New York Queens Medicine and Surgery, P.C. Pediatrics Past Accepting new patients
Newyork-Presbyterian/Queens Pediatrics Past Accepting new patients
Long Island Jewish Medical Center Past Accepting new patients
Long Island Jewish Medical Center Past Accepting new patients
North Shore University Hospital Past Accepting new patients
Flushing Hospital & Medical Center Past Accepting new patients

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1396842316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11220 71ST RD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754643",
            "telephone_number": "718-520-7776",
            "fax_number": "718-520-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11206 71ST RD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754643",
            "telephone_number": "718-520-8585",
            "fax_number": "718-520-8688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKHALOV",
        "first_name": "ARKADIY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "221398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02169102",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.