Gregg Ilan Khodorov, MD, MBA

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

25MA13037300 Issued in NJ

Practice address

136 Route 73 Ste a
Voorhees, NJ 08043-9598

Phone

(877) 388-2778

NPI assigned

Apr 9, 2020

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 PA

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

Master of Business Administration, Doctor of Medicine

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 and National Provider Directory roles.

• Methodist Associates in Healthcare, Inc

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1053355131
  Medicare reassignment NPD
• Methodist Associates in Healthcare, Inc

  • Neurological Surgery Physician
  • Philadelphia, PA
  • NPI 1790390813
  NPD

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1518586536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 ROUTE 73 STE A",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080439598",
            "telephone_number": "877-388-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHODOROV",
        "first_name": "GREGG",
        "middle_name": "ILAN",
        "credential": "MD, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-09",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NJ",
            "license": "25MA13037300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rishel Kerns
• Brittany Kervick, LSW
• Martin Jay Kessler, M.D.
• Taylor Ashley Keyser, COTA
• Bushra Khan
• Hyein Kil, DO
• Hannah Kim, MD
• Luke Young Joong Kim, M.D.
• Mirye Kim, MD
• Jared King

• Vascular & Interventional Radiology Physician in Voorhees, NJ
• Providers in Voorhees, NJ by specialty
• Vascular & Interventional Radiology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; 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.