Individual provider Active NPI

Khaim Babayev, PA

  • Surgical Physician Assistant
  • Forest Hills, NY
National Provider Identifier
1487732616
Registry record updated May 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
007572-1 Issued in NY
Practice address
10201 66TH Rd
Forest Hills, NY 11375-2029
Phone
(718) 830-4093
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 007572-1 NY Primary

Addresses

Primary practice location

10201 66TH Rd
Forest Hills, NY 11375-2029

Mailing address

10201 66TH Rd
Forest Hills, NY 11375-2029
Phone (718) 830-4093

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040630000189 NY Practitioner - Physician Assistant 9537146402 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
007572-1NYMDPhysical Therapy Assistant
007572NYMDSpeech-Language Pathologist

Practice roles (1 of 5)

OrganizationSpecialtyStatusNew patients
No. Shore Emergency Med at Forest Hill Past Accepting new patients

Networks

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

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274659200000",
    "number": "1487732616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10201 66TH RD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752029",
            "telephone_number": "718-830-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10201 66TH RD",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113752029",
            "telephone_number": "718-830-4093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABAYEV",
        "first_name": "KHAIM",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2010-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "007572-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.