Individual provider Active NPI

Khatuna Topadze Belov, MD

  • Family Medicine Physician
  • Ridgewood, NJ
National Provider Identifier
1881699528
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MA07761000 Issued in NJ
Practice address
127 Union St
Ste 102
Ridgewood, NJ 07450-4436
Phone
(201) 857-0066
Fax
(201) 857-5038
NPI assigned
Jun 18, 2005
Last updated
Oct 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 25MA07761000 NJ
Family Medicine Physician 207Q00000X 25MA07761000 NJ Primary

Addresses

Primary practice location

127 Union St
Ste 102
Ridgewood, NJ 07450-4436

Mailing address

127 Union St
Ste 102
Ridgewood, NJ 07450-4436
Phone (201) 445-0033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20050927001004 NJ Practitioner - Family PracticePractitioner - Internal Medicine 2264467463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1990
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

127 Union St
Suite 102
Ridgewood, NJ 07450-4436
Phone (201) 857-0066

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Khatuna Belov, MD, LLC General Practice CurrentSince Jan 3, 2015 Accepting new patients
Valley Physician Services, Inc. General Practice Past Accepting new patients

Locations

127 Union St
Ste 102
Ridgewood, NJ 07450
Phone (201) 493-2004

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1119052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1881699528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 UNION ST",
            "address_2": "STE 102",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504436",
            "telephone_number": "201-445-0033",
            "fax_number": "201-857-0453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 UNION ST",
            "address_2": "STE 102",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504436",
            "telephone_number": "201-857-0066",
            "fax_number": "201-857-5038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELOV",
        "first_name": "KHATUNA",
        "middle_name": "TOPADZE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-18",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NJ",
            "license": "25MA07761000",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA07761000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

Verify at the official NPI Registry.