Individual provider Active NPI

Zinaida Khaimchayev

  • Adult Psychiatric/Mental Health Registered Nurse
  • Queens Village, NY
National Provider Identifier
1811496888
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X
License
613583 Issued in NY
Practice address
7925 Winchester Blvd
Queens Village, NY 11427-2128
Phone
(718) 264-4005
NPI assigned
Feb 6, 2018
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 613583 NY Primary

Addresses

Primary practice location

7925 Winchester Blvd
Queens Village, NY 11427-2128

Mailing address

79-25 Wincherster Blvd.
Queens Village, NY 11427

Other practice location 1

7925 Winchester Blvd
Queens Village, NY 11427-2128
Phone (718) 264-4005

Other practice location 2

7925 Winchester Blvd
Queens Village, NY 11427-2128
Phone (718) 264-4005

Other practice location 3

79-25 winchester blvd
queens village, NY 11427
Phone (718) 264-4005

Other identifiers 1

IdentifierTypeStateIssuer
50150MedicaidNY

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
613583NYMDAdult Psychiatric/Mental Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1517875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1811496888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79-25 WINCHERSTER BLVD.",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "11427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7925 WINCHESTER BLVD",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114272128",
            "telephone_number": "718-264-4005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7925 Winchester Blvd",
            "address_purpose": "LOCATION",
            "city": "Queens Village",
            "state": "NY",
            "postal_code": "114272128",
            "country_code": "US",
            "telephone_number": "718-264-4005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7925 Winchester Blvd",
            "address_purpose": "LOCATION",
            "city": "Queens Village",
            "state": "NY",
            "postal_code": "114272128",
            "country_code": "US",
            "telephone_number": "718-264-4005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "79-25 winchester blvd",
            "address_purpose": "LOCATION",
            "city": "queens village",
            "state": "NY",
            "postal_code": "11427",
            "country_code": "US",
            "telephone_number": "718-264-4005",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHAIMCHAYEV",
        "first_name": "ZINAIDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "NY",
            "license": "613583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50150",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Queens Village, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.