Individual provider Active NPI

Regina Khaimova

  • Orthopedic Physical Therapist
  • Forest Hills, NY
National Provider Identifier
1780833400
Registry record updated Oct 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Practice address
110-59 63 Avenue
Forest Hills, NY 11375-1716
Phone
(917) 561-2555
NPI assigned
Sep 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X Primary

Addresses

Primary practice location

110-59 63 Avenue
Forest Hills, NY 11375-1716

Mailing address

11059 63Rd Ave
Forest Hills, NY 11375-1405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mobilecare Physical Therapy, PC CurrentSince Feb 23, 2020 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412208000000",
    "number": "1780833400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11059 63RD AVE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110-59 63 AVENUE",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751716",
            "telephone_number": "917-561-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAIMOVA",
        "first_name": "REGINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-17",
        "last_updated": "2014-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.