NPIMap

Individual provider Active NPI

Mara Khaylomskaya, M.D

  • Internal Medicine Physician
  • New York, NY
National Provider Identifier
1417992322
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
211036 Issued in NY
Practice address
1 Park Ave
10TH Floor
New York, NY 10016-5802
Phone
(646) 754-4506
Fax
(212) 307-0759
NPI assigned
Jun 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 211036 NY Primary

Addresses

Primary practice location

1 Park Ave
10TH Floor
New York, NY 10016-5802

Mailing address

1 Park Ave
10TH Floor
New York, NY 10016-5802
Phone (646) 754-4506

Other identifiers 1

IdentifierTypeStateIssuer
01878284MedicaidNY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mkhaylomskaya98763@nyumc.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050504000740 NY Practitioner - Internal Medicine 6406896943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New York UniversityGroup PAC ID 1355232422, 5,925 clinicians

Practice addresses (Care Compare)

111 Broadway
New York, NY 10006-1901
Phone (212) 263-9700

1220 Ave P
Brooklyn, NY 11229-1009
Phone (718) 376-1004

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.8 of 100Reported as group
Quality
91.79
Promoting interoperability
100
Improvement activities
40
Cost
75.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
211036NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University Internal Medicine CurrentSince Jan 1, 2015 Accepting new patients
New York University Internal Medicine CurrentSince Jan 1, 2015 Accepting new patients

Locations

1220 Avenue P
Brooklyn, NY 11229
Phone (718) 375-7546

1 Park Ave
Fl 10
New York, NY 10016
Phone (212) 404-3715

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Networks

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

Organizations & group practices 2

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1417992322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PARK AVE",
            "address_2": "10TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165802",
            "telephone_number": "646-754-4506",
            "fax_number": "212-307-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PARK AVE",
            "address_2": "10TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165802",
            "telephone_number": "646-754-4506",
            "fax_number": "212-307-0759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAYLOMSKAYA",
        "first_name": "MARA",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-17",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "211036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01878284",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkhaylomskaya98763@nyumc.direct-ci.com",
            "affiliation": "N",
            "address_1": "1 Park Ave",
            "address_2": "10th Floor",
            "city": "New York",
            "state": "NY",
            "country_code": "US",
            "postal_code": "100165802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.