Vitaliy Khaldarov, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

218084 Issued in NY

Practice address

19615 75TH Ave
Flushing, NY 11366-1813

Phone

(917) 816-4597

NPI assigned

Dec 7, 2005

Last updated

May 27, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Garden Medical Consulting PLLCGroup PAC ID 4183143209, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Garden Medical Consulting PLLC

  • Psychiatry Physician
  • Fresh Meadows, NY
  • NPI 1487444386
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274918400000",
    "number": "1609851195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19615 75TH AVE",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "11366",
            "telephone_number": "917-816-4597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19615 75TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113661813",
            "telephone_number": "917-816-4597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHALDAROV",
        "first_name": "VITALIY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2010-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "218084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTION",
            "identifier": "464106",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "581076",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02119253",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLAN",
            "identifier": "P2574904",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yulianna Khaimov
• Bella Khaimova
• Evelina Khaimova, RN-IBCLC
• Liana Khaimova
• Anastasia Khaitov, DDS
• Samra Khalid, MD
• Alvi Faisal Khan, MBBS, MD
• Faizool Khan, R.P.A.C.
• Haya Khan
• Jennifer Khan, R.N.

• Psychiatry Physician in Flushing, NY
• Providers in Flushing, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2010; 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.