Individual provider Active NPI

Nargiza Khikmatova

  • Medical Physician Assistant
  • Morristown, NJ
National Provider Identifier
1942663992
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
25MP00607300 Issued in NJ
Practice address
100 Madison Ave # Gagnonc
Morristown, NJ 07960-6136
Phone
(973) 971-8994
Fax
(973) 898-1600
NPI assigned
Mar 29, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 019611 NY
Medical Physician Assistant 363AM0700X 25MP00607300 NJ Primary

Addresses

Primary practice location

100 Madison Ave # Gagnonc
Morristown, NJ 07960-6136

Mailing address

PO Box 416457
Boston, MA 02241-6457
Phone (844) 362-1735

Other practice location 1

34 Seaman Ave Apt 4C
New York, NY 10034-2991
Phone (347) 209-8758

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160715001583 NY Practitioner - Physician Assistant 8628360351 Reassigns benefits to 1 organization
I20231017000724 NJ Practitioner - Physician Assistant 8628360351 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
019611NYMDOccupational Therapist
25MP00607300NJMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Montefiore Medical Center CurrentSince May 12, 2016 Accepting new patients
Montefiore Medical Center CurrentSince May 12, 2016 Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1942663992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 416457",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022416457",
            "telephone_number": "844-362-1735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MADISON AVE # GAGNONC",
            "city": "MORRISTOWN",
            "state": "NJ",
            "postal_code": "079606136",
            "telephone_number": "973-971-8994",
            "fax_number": "973-898-1600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34 Seaman Ave Apt 4C",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100342991",
            "country_code": "US",
            "telephone_number": "347-209-8758",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHIKMATOVA",
        "first_name": "NARGIZA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019611",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00607300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, NJ

Sources for this page

Verify at the official NPI Registry.