Individual provider Active NPI

Nadegda Kandchorov

  • Family Nurse Practitioner
  • Fresh Meadows, NY
National Provider Identifier
1962241109
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F353465 Issued in NY
Practice address
7315 194TH St
Fresh Meadows, NY 11366-1835
Phone
(917) 535-1505
NPI assigned
May 20, 2024
Last updated
May 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F353465 NY Primary

Addresses

Primary practice location

7315 194TH St
Fresh Meadows, NY 11366-1835

Mailing address

7315 194TH St
Fresh Meadows, NY 11366-1835
Phone (917) 535-1505

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250826004904 NY Practitioner - Nurse Practitioner 9133629793 Reassigns benefits to 1 organization
Practice locations: Fresh Meadows, NY

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10 Bond St
Great Neck, NY 11021-2454

125 Mineola Ave
Suite 200
Roslyn Heights, NY 11577-2023

125 Mineola Ave
Suite 200
Roslyn Heights, NY 11577-2042

18907 Union Tpke
Fresh Meadows, NY 11366-1861
Phone (347) 336-5972

7315 194TH St
Fresh Meadows, NY 11366-1835

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F353465NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
New York Bariatric Surgery Group PLLC CurrentSince Apr 13, 2026 Accepting new patients
Long Island Minimally Invasive Surgery, P.C. CurrentSince Apr 13, 2026 Accepting new patients
Dabakarov Family Health Nurse Practitioner PC CurrentSince May 26, 2024 Accepting new patients
Allergy Asthma and Eczema Care of Queens PC PastSince Dec 8, 2024 Accepting new patients

Locations

646 Park Ave
New York, NY 10065
Phone (212) 249-0404

125 Mineola Ave
Ste 200
Roslyn Hts, NY 11577
Phone 5166165500800

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1962241109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7315 194TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661835",
            "telephone_number": "917-535-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7315 194TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661835",
            "telephone_number": "917-535-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANDCHOROV",
        "first_name": "NADEGDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F353465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

Verify at the official NPI Registry.