Veronica Khaimov OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV006785 Issued in NY

Legal business name

VERONICA KHAIMOV OD PC

Practice address

14432 68TH Ave
Flushing, NY 11367-1327

Phone

(917) 975-5631

Fax

(718) 544-1048

NPI assigned

Oct 24, 2012

Organization subpart

No

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

Authorized official

Name

Veronica Khaimov, ODNPI 1053447904

Title

President

Phone

(917) 975-5631

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 2

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

• Veronica Khaimov, O.D.

  • Optometrist
  • Flushing, NY
  • NPI 1053447904
  Medicare reassignment NPD Authorized official
• Aleksandr Khaimov, D.O

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Forest Hills, NY
  • NPI 1134323132
  NPD (past)

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

{
    "created_epoch": "1351036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351036800000",
    "number": "1972856292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14432 68TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671327",
            "telephone_number": "917-975-5631",
            "fax_number": "718-544-1048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14432 68TH AVE",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671327",
            "telephone_number": "917-975-5631",
            "fax_number": "718-544-1048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERONICA KHAIMOV OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-24",
        "last_updated": "2012-10-24",
        "status": "A",
        "authorized_official_last_name": "KHAIMOV",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-975-5631",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Flushing, NY
• Providers in Flushing, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.