Dmitriy O. Khodorskiy, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

265957 Issued in NY

Practice address

222 Station PLZ N Ste 429
Mineola, NY 11501-3889

Phone

(516) 663-4623

Fax

(516) 663-8500

NPI assigned

Jul 10, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 1

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

Gastroenterology

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Triborough Gi PLLCGroup PAC ID 2466761531, 15 clinicians

Century Medical and Dental Center IncGroup PAC ID 8729070669, 107 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• New York Community Hospital of Brooklyn, Inc. Hospital, Brooklyn, NY, CCN 330019

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: dmitriykhodorskiy@mai.allscriptsdirect.net

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.

• Century Medical & Dental Center Inc

  • Health Service Clinic/Center
  • Brooklyn, NY
  • NPI 1144399098
  Medicare reassignment Care Compare group NPD
• Triborough Gi PLLC

  • Gastroenterology Physician
  • Brooklyn, NY
  • NPI 1255711339
  Medicare reassignment Care Compare group NPD
• Chinatown True Care Medical PLLC

  • Internal Medicine Physician
  • New York, NY
  • NPI 1912567884
  Medicare reassignment NPD
• Maimonides Faculty Practice Plan

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1053344846
  Medicare reassignment NPD
• Maimonides Medical Center - MMC Gastroenterology FPP

  • Gastroenterology Physician
  • Brooklyn, NY
  • NPI 1932216660
  Medicare reassignment NPD
• Maimonides Medical Center Maimonides Primary Care FPP

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1013968593
  Medicare reassignment NPD
• Maimonides Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1093777492
  NPD
• Triborough Gi PLLC

  • Clinical Medical Laboratory
  • Brooklyn, NY
  • NPI 1932820339
  NPD
• Suny Downstate Medical Center

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1699704155
  NPD (past)
• NJ-Ny Gastroenterology Associate

  • Specialist
  • Metuchen, NJ
  • NPI 1548655160
  NPD (past)

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

• New York Community Hospital of Brooklyn Inc

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1215030697
  Care Compare affiliation

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

{
    "created_epoch": "1247184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496707200000",
    "number": "1689803736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 STATION PLZ N STE 429",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013889",
            "telephone_number": "516-663-4623",
            "fax_number": "516-663-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 STATION PLZ N STE 429",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013889",
            "telephone_number": "516-663-4623",
            "fax_number": "516-663-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHODORSKIY",
        "first_name": "DMITRIY",
        "middle_name": "O.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-10",
        "last_updated": "2017-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A132741",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "265957",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "054753",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CT",
            "license": "054753",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "A132741",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "265957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03530641",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ankur Khanna, D.O.
• Shray Khanna, MD
• Chaula Sunil Kharode, M.D.
• Minesh Khatri, MD
• Lin Lin Khine, MD
• Homa Khowaja, PA-C
• Poonam Khullar, M.D.
• Abaan Khurshid, DO
• Roget George Kidd, NP
• Michael Franics Kildare, PA-C

• Gastroenterology Physician in Mineola, NY
• Providers in Mineola, NY by specialty
• Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2017; 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.