Alexei Kartachov, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

223791 Issued in NY

Practice address

3375 Park Ave
Suite 3003-1
Wantagh, NY 11793-3733

Phone

(516) 469-0638

Fax

(516) 679-0486

NPI assigned

Apr 25, 2006

Last updated

Dec 16, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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

Psychiatry

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

County of SuffolkGroup PAC ID 2264344316, 8 clinicians

Phoenix Houses of Long Island IncGroup PAC ID 4880584101, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• County of Suffolk

  dba Suffolk County Department of Health Services

  • Public Health or Welfare Agency
  • Great River, NY
  • NPI 1285750737
  Medicare reassignment Care Compare group NPD
• Phoenix Houses of Long Island, Inc.

  • Substance Abuse Rehabilitation Facility
  • Brentwood, NY
  • NPI 1174691281
  Medicare reassignment Care Compare group
• Comprehensive Mental Health

  • Psychiatry Physician
  • Wantagh, NY
  • NPI 1265512941
  Authorized official Same address or phone
• County of Suffolk

  • Methadone Clinic
  • Smithtown, NY
  • NPI 1649374851
  NPD
• Suffolk County Department of Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Farmingville, NY
  • NPI 1700989050
  NPD
• Park Slope Center for Mental Health, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brooklyn, NY
  • NPI 1851382188
  NPD (past)

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292457600000",
    "number": "1780640086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2772 LEE PL",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117105000",
            "telephone_number": "516-469-0638",
            "fax_number": "516-679-0486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3375 PARK AVE",
            "address_2": "SUITE 3003-1",
            "city": "WANTAGH",
            "state": "NY",
            "postal_code": "117933733",
            "telephone_number": "516-469-0638",
            "fax_number": "516-679-0486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARTACHOV",
        "first_name": "ALEXEI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2010-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "223791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02647872",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sachin Kamath, M.D.
• K.T. Kamins
• Kristen Ann Kannengeiser, M.S.
• Lalita Kapoor, RN
• William Steven Kappel, D.D.S.
• Rita Kavanagh
• Nicole Marlene Keating, MSED
• Nancy Keelan, LMSW
• Sean Jeffrey Keller, MD
• Sinead Mary Kennedy, LCSW, CASAC

• Psychiatry Physician in Wantagh, NY
• Providers in Wantagh, 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 Dec 16, 2010; 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.