NPIMap

Individual provider Active NPI

Sergey Khaitov, M.D.

  • Surgery Physician
  • New York, NY
National Provider Identifier
1932369816
Registry record updated Jan 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
235880 Issued in NY
Practice address
5 E 98TH St, 14TH FL
Suite C
New York, NY 10029-6501
Phone
(212) 241-1763
Fax
(212) 241-5975
NPI assigned
Jun 13, 2008
Last updated
Jan 25, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 235880 NY Primary

Addresses

Primary practice location

5 E 98TH St, 14TH FL
Suite C
New York, NY 10029-6501

Mailing address

5 E 98TH St, 15TH FL
Box 1259
New York, NY 10029-6501
Phone (212) 241-1763

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090619000498 NY Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 5698826352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)Also: General Surgery
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Gustave L Levy PL
New York, NY 10029-6504
Phone (212) 241-6500

5 E 98TH St
Surgery Dept
New York, NY 10029-6501
Phone (212) 241-6591

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
235880NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Nov 1, 2013 Accepting new patients
Icahn School of Medicine at Mount Sinai Surgery CurrentSince Nov 1, 2013 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Mount Sinai Hospital Past Accepting new patients
Mount Sinai School of Medicine Surgery Past Accepting new patients
Mount Sinai Hospital Past Accepting new patients

Locations

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

5 E 98th St
New York, NY 10029
Phone (212) 241-3986

5 E 98th St
Fl 14
New York, NY 10029
Phone (212) 241-7646

5 E 98th St
Fl 15
New York, NY 10029
Phone (212) 241-5871

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Organizations & group practices 6

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 6

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": "1213315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264377600000",
    "number": "1932369816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 E 98TH ST, 15TH FL",
            "address_2": "BOX 1259",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296501",
            "telephone_number": "212-241-1763",
            "fax_number": "212-241-5975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 E 98TH ST, 14TH FL",
            "address_2": "SUITE C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296501",
            "telephone_number": "212-241-1763",
            "fax_number": "212-241-5975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAITOV",
        "first_name": "SERGEY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-13",
        "last_updated": "2010-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "235880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.