Organization Active NPI

Kayrov Medical P.C.

  • Family Medicine Physician
  • Far Rockaway, NY
National Provider Identifier
1720318785
Registry record updated Jan 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
227968 Issued in NY
Legal business name
KAYROV MEDICAL P.C.
Practice address
5115 Beach Channel Dr
Far Rockaway, NY 11691-1042
Phone
(718) 734-2444
Fax
(718) 734-2808
NPI assigned
Jan 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2010

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

Authorized official

Name
Dr. Valeriy Kayrov, D.O.NPI 1649214305
Title
President
Phone
(718) 734-2444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 227968 NY Primary

Addresses

Primary practice location

5115 Beach Channel Dr
Far Rockaway, NY 11691-1042

Mailing address

753 Hillcrest PL
Valley Stream, NY 11581-3127
Phone (718) 734-2444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100617000537 NY Part B Supplier - Clinic/Group Practice 4284764234 Receives reassigned benefits from 1 practitioner
Practice locations: Lawrence, NY

National Provider Directory

National Provider Directory

Locations

5115 Beach Channel Dr
Far Rockaway, NY 11691
Phone (718) 734-2000

290 Central Ave
Ste 212
Lawrence, NY 11559
Phone (516) 341-7979

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263340800000",
    "number": "1720318785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "753 HILLCREST PL",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115813127",
            "telephone_number": "718-734-2444",
            "fax_number": "718-734-2808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 BEACH CHANNEL DR",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116911042",
            "telephone_number": "718-734-2444",
            "fax_number": "718-734-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAYROV MEDICAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-13",
        "last_updated": "2010-01-13",
        "status": "A",
        "authorized_official_last_name": "KAYROV",
        "authorized_official_first_name": "VALERIY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-734-2444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "227968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.