Ofer Haidatov, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

346340 Issued in NY

Practice address

7536 Bell Blvd Apt 6B
Oakland Gardens, NY 11364-3434

Phone

(646) 898-7422

NPI assigned

Aug 10, 2020

Last updated

Aug 10, 2020By the provider in NPPES

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pain Physicians Ny PLLCGroup PAC ID 3870779143, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Pain Physicians Ny PLLC

  • Interventional Pain Medicine Physician
  • New York, NY
  • NPI 1538465497
  Medicare reassignment Care Compare group NPD
• Big Leap Medical Group PA

  • Neurological Surgery Physician
  • New York, NY
  • NPI 1821841503
  NPD (past)

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1487265922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7536 BELL BLVD APT 6B",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113643434",
            "telephone_number": "646-898-7422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7536 BELL BLVD APT 6B",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113643434",
            "telephone_number": "646-898-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAIDATOV",
        "first_name": "OFER",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-10",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "346340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Anne Gretton, MA, CCC-SLP
• Absar Haaris, D.O.
• Sherlin Haghnazari
• Haidatov Optometry PC (Oakland Gardens Eye Care)
• Kristina Haidatov, OD
• Claire M. Haines, OTR/L
• Farid Hakimzadeh, DDS
• Asim Hameedi
• Eunmi Han
• Joanne Han

• Family Nurse Practitioner in Oakland Gardens, NY
• Providers in Oakland Gardens, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.