NPIMap

Organization Active NPI

Triborough Medical PLLC

  • Anesthesiology Physician
  • Fresh Meadows, NY
National Provider Identifier
1922651918
Registry record updated Jun 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
TRIBOROUGH MEDICAL PLLC
Practice address
77-36 169 Street 1St Floor
Fresh Meadows, NY 11366
Phone
(718) 878-4656
Fax
(718) 889-7444
NPI assigned
Jul 19, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2023

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

Authorized official

Name
Dr. Daniel Khaimov, MDNPI 1750545307
Title
Authorized Official
Phone
(718) 878-4656

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

77-36 169 Street 1St Floor
Fresh Meadows, NY 11366

Mailing address

200 Broadway
Brooklyn, NY 11211
Phone (718) 302-1800

National Provider Directory

National Provider Directory

Locations

200 Broadway
Ste 3239
Brooklyn, NY 11211

15031 Union Tpke
Ofc Of
Flushing, NY 11367

7736 169th St
Ste 1
Fresh Meadows, NY 11366
Phone (718) 878-4656

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687651200000",
    "number": "1922651918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BROADWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11211",
            "telephone_number": "718-302-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77-36 169 STREET 1ST FLOOR",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "11366",
            "telephone_number": "718-878-4656",
            "fax_number": "718-889-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIBOROUGH MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-19",
        "last_updated": "2023-06-25",
        "certification_date": "2023-06-25",
        "status": "A",
        "authorized_official_last_name": "KHAIMOV",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "718-878-4656",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2023; 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.