Michelle Khaimov

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

12 Old Colony LN
Great Neck, NY 11023-1624

Phone

(718) 290-3353

NPI assigned

Sep 22, 2026

Last updated

Sep 22, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1790035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1780596841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 OLD COLONY LN",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110231624",
            "telephone_number": "718-290-3353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 OLD COLONY LN",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110231624",
            "telephone_number": "718-290-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAIMOV",
        "first_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-22",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Kershis, DPT
• Edmund Kessler, M.D.
• Martin E. Kessler, M.D.,F.A.C.S.
• Michael Khadavi, MD
• Boris Khaimov, D.O,
• Azam Zari Khaledi, D.M.D
• Ayesha Khalid, MD
• Dvora Khalili
• Deborah Khalou, PHARM.D.
• Aneisa B. Khan, OTD, OTR/L

• Physician Assistant in Great Neck, NY
• Providers in Great Neck, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.