Boris Khaimov, D.O,

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

249224 Issued in NY

Practice address

11 Grace Ave Ste 204
Great Neck, NY 11021-2417

Phone

(917) 551-6652

NPI assigned

May 22, 2007

Last updated

Feb 15, 2022By 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 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Comprehensive Medical Assist P.C.

  • Surgical Physician Assistant
  • Great Neck, NY
  • NPI 1194172890
  NPD Authorized official
• Comprehensive Medical Assist P.C.

  • Surgical Physician Assistant
  • Manalapan, NJ
  • NPI 1578011177
  NPD Authorized official
• Boris Khaimov, DO PLLC

  • Psychiatry Physician
  • Garden City, NY
  • NPI 1588595805
  NPD (past) Authorized official

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1720297872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6725 DARTMOUTH ST",
            "address_2": "3N",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754058",
            "telephone_number": "171-826-3382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 GRACE AVE STE 204",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110212417",
            "telephone_number": "917-551-6652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAIMOV",
        "first_name": "BORIS",
        "credential": "D.O,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "249224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Jay Kerpen, D.M.D.
• Ryan Kershis, DPT
• Edmund Kessler, M.D.
• Martin E. Kessler, M.D.,F.A.C.S.
• Michael Khadavi, MD
• Michelle Khaimov
• Azam Zari Khaledi, D.M.D
• Ayesha Khalid, MD
• Dvora Khalili
• Deborah Khalou, PHARM.D.

• Psychiatry Physician in Great Neck, NY
• Providers in Great Neck, 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 Feb 15, 2022; 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.