Nagmo M Fatakhova, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

219009 Issued in NY

Practice address

9520 63Rd Rd Ste J
Rego Park, NY 11374-1145

Phone

(858) 279-1223

Fax

(619) 516-4757

NPI assigned

Jul 20, 2006

Last updated

Oct 4, 2018By the provider in NPPES

Sex

Female

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 2

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, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Queens Psychiatric and Medical Care P.C.Group PAC ID 0244521714, 4 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.

• Queens Psychiatric & Medical Care P.C.

  • Psychiatry Physician
  • Rego Park, NY
  • NPI 1497119846
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538611200000",
    "number": "1821018359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 KEARNY VILLA RD",
            "address_2": "SUITE116",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231578",
            "telephone_number": "858-279-1223",
            "fax_number": "619-295-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9520 63RD RD STE J",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741145",
            "telephone_number": "858-279-1223",
            "fax_number": "619-516-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATAKHOVA",
        "first_name": "NAGMO",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2018-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "219009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04321399",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00622960",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jack Jienan Fang, M.D.
• Farnaz Fahimirad
• Fasttrack Urgent Care PLLC
• Rosy Fatakhov
• Vitaliy Fatakhov, FNP
• Yekaterina Fatakhova, MD
• Natella Fayzibayev
• Daniel Fayziyev
• Natalya Fazylova, NP
• FCN Surgery Center, LLC

• Psychiatry Physician in Rego Park, NY
• Providers in Rego Park, 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 Oct 4, 2018; 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.