NPIMap

Individual provider Active NPI

Alex David Khromov, M.D.

  • Specialist
  • Deltona, FL
National Provider Identifier
1689787707
Registry record updated Dec 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME96564 Issued in FL
Practice address
1565 Saxon Blvd
Suite 204
Deltona, FL 32725-5876
Phone
(386) 742-4343
Fax
(386) 742-1323
NPI assigned
Aug 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME96564 FL Primary

Addresses

Primary practice location

1565 Saxon Blvd
Suite 204
Deltona, FL 32725-5876

Mailing address

1565 Saxon Blvd
Suite 204
Deltona, FL 32725-5876
Phone (386) 742-4343

Other identifiers 1

IdentifierTypeStateIssuer
FLORIDA STATE LICENSOtherFLME96564

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070507000547 FL Practitioner - Interventional Pain ManagementPractitioner - Physical Medicine and Rehabilitation 9537265640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Physical Medicine and Rehabilitation
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
SSP Medicine IncGroup PAC ID 0143382788, 2 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

1565 Saxon Blvd
Suite 204
Deltona, FL 32725-5836
Phone (386) 742-4343

Hospital & facility affiliations

  • Lucent Health, LLC Home health agency, Daytona Beach, FL, CCN 687112
  • Adventhealth Deland Hospital, Deland, FL, CCN 100045
  • Adventhealth Fish Memorial Hospital, Orange City, FL, CCN 100072
  • Majestic Oaks Nursing home, Orange City, FL, CCN 105374

Merit-based Incentive Payment System (MIPS)

Final score
95.96 of 100Reported as group
Quality
98.21
Improvement activities
40
Cost
79.6

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
SSP Medicine Inc CurrentSince Sep 1, 2008 Accepting new patients
Florida Pain and Rehabilitation Institute Inc Past Accepting new patients
Florida Pain & Rehabilitation Institute Inc Past Accepting new patients
Florida Pain & Rehabilitation Institute Inc Past Accepting new patients

Locations

1565 Saxon Blvd
Ste 204
Deltona, FL 32725
Phone (386) 742-4343

1979 Longwood Lake Mary Rd
Ste 1001
Longwood, FL 32750

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228435200000",
    "number": "1689787707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 SAXON BLVD",
            "address_2": "SUITE 204",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327255876",
            "telephone_number": "386-742-4343",
            "fax_number": "386-742-1323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 SAXON BLVD",
            "address_2": "SUITE 204",
            "city": "DELTONA",
            "state": "FL",
            "postal_code": "327255876",
            "telephone_number": "386-742-4343",
            "fax_number": "386-742-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHROMOV",
        "first_name": "ALEX",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2008-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME96564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ME96564",
            "identifier": "FLORIDA STATE LICENS",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deltona, FL

Sources for this page

Verify at the official NPI Registry.