Individual provider Active NPI

Artemiy Kokhanov, MD

  • Neonatal-Perinatal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1568858199
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
72458 Issued in AZ
Practice address
1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone
(602) 933-6345
Fax
(602) 933-8975
NPI assigned
Apr 10, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X A155154 CA
Neonatal-Perinatal Medicine Physician 2080N0001X 80640 MN
Pediatrics Physician 208000000X U1062 TX
Neonatal-Perinatal Medicine Physician 2080N0001X U1062 TX
Neonatal-Perinatal Medicine Physician 2080N0001X 72458 AZ Primary

Addresses

Primary practice location

1919 E Thomas Rd
Phoenix, AZ 85016-7710

Mailing address

2108 E Thomas Rd Ste 130
Phoenix, AZ 85016-0008
Phone (602) 933-3124

Other practice location 1

4801 Alberta Ave
El Paso, TX 79905-2707
Phone (915) 215-5700

Other practice location 2

400 E 3rd St
Duluth, MN 55805-1951
Phone (218) 786-8364

Other practice location 3

4815 Alameda Ave
El Paso, TX 79905-2705
Phone (915) 215-5700

Other practice location 4

2201 Hempstead Turnpike
Dept. of Pediatrics
East Meadow, NY 11554
Phone (516) 572-6177

Other practice location 5

4845 Alameda Ave
El Paso, TX 79905-2705
Phone (915) 215-5700

Other identifiers 1

IdentifierTypeStateIssuer
209736MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX, AZ3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20210528001069 CA Practitioner - Pediatric Medicine 3577962216 Reassigns benefits to 1 organization
I20221227000315 TX Practitioner - Pediatric Medicine 3577962216 Reassigns benefits to 1 organization
I20240419003299 AZ Practitioner - Pediatric Medicine 3577962216 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
U1062TXMDPediatrics Physician
72458AZMDNeonatal-Perinatal Medicine Physician
A155154CAMDNeonatal-Perinatal Medicine Physician
80640MNMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Hospital Pediatrics Current Accepting new patients
Texas Tech University Health Sciences Center El Paso Pediatrics CurrentSince Feb 1, 2023 Accepting new patients
County of Los Angeles CurrentSince May 10, 2021 Accepting new patients
Phoenix Children'S Medical Group CurrentSince Mar 10, 2024 Accepting new patients
Texas Tech University Health Sciences Center El Paso CurrentSince Feb 1, 2023 Accepting new patients
Phoenix Children'S Medical Group CurrentSince Mar 10, 2024 Accepting new patients
County of Los Angeles Current Accepting new patients
Texas Tech University Health Sciences Center El Paso Current Accepting new patients
County of Los Angeles Auditor Controller CurrentSince May 10, 2021 Accepting new patients
Texas Tech University Health Sciences Center Odessa Family Medicine PastSince Dec 18, 2022 Accepting new patients
Dignity Health Past Accepting new patients

Locations

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

2108 E Thomas Rd
Ste 130
Phoenix, AZ 85016

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

4845 Alameda Ave
El Paso, TX 79905
Phone (915) 215-5700

4815 Alameda Ave
El Paso, TX 79905
Phone (915) 215-6000

4801 Alberta Ave
El Paso, TX 79905
Phone (915) 215-5200

Organizations & group practices 11

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": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1568858199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 E THOMAS RD STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850160008",
            "telephone_number": "602-933-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850167710",
            "telephone_number": "602-933-6345",
            "fax_number": "602-933-8975"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4801 Alberta Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799052707",
            "country_code": "US",
            "telephone_number": "915-215-5700",
            "fax_number": "915-215-8872",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 E 3rd St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558051951",
            "country_code": "US",
            "telephone_number": "218-786-8364",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4815 Alameda Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799052705",
            "country_code": "US",
            "telephone_number": "915-215-5700",
            "fax_number": "915-215-8872",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2201 Hempstead Turnpike",
            "address_2": "Dept. of Pediatrics",
            "address_purpose": "LOCATION",
            "city": "East Meadow",
            "state": "NY",
            "postal_code": "11554",
            "country_code": "US",
            "telephone_number": "516-572-6177",
            "fax_number": "516-572-5483",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4845 Alameda Ave",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799052705",
            "country_code": "US",
            "telephone_number": "915-215-5700",
            "fax_number": "915-215-8872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOKHANOV",
        "first_name": "ARTEMIY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-10",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CA",
            "license": "A155154",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MN",
            "license": "80640",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "U1062",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "TX",
            "license": "U1062",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "AZ",
            "license": "72458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209736",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.