PROKHOROV'S PEDIATRICS AND CHILD NEUROLOGY PC
NPI 1104132778
Pediatrics in Rego Park, NY
About Prokhorov's Pediatrics And Child Neurology Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PROKHOROV'S PEDIATRICS AND CHILD NEUROLOGY PC (NPI 1104132778) is a healthcare organization registered as a pediatrics in Rego Park, New York and active in the NPI registry since August 2010. The organization lists Svetlana Prokhorova, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Prokhorov's Pediatrics And Child Neurology Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Prokhorov's Pediatrics And Child Neurology PC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Prokhorov's Pediatrics And Child Neurology PC's NPI number?
The NPI number for Prokhorov's Pediatrics And Child Neurology PC is 1104132778. It was assigned to this organization in the NPPES registry on August 20, 2010.
Where is Prokhorov's Pediatrics And Child Neurology PC located?
Prokhorov's Pediatrics And Child Neurology PC is located at 9817 Queens Blvd Ll2, Rego Park, NY 11374. The listed phone number is (718) 275-5600.
What is Prokhorov's Pediatrics And Child Neurology PC's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Prokhorov's Pediatrics And Child Neurology PC enrolled in Medicare?
Yes. Prokhorov's Pediatrics And Child Neurology PC is registered in the Medicare PECOS enrollment system.
When is Prokhorov's Pediatrics And Child Neurology PC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New York, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Prokhorov's Pediatrics And Child Neurology PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Prokhorov's Pediatrics And Child Neurology PC, in Neurology and Pediatric Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Prokhorov's Pediatrics And Child Neurology PC was last updated on June 3, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Prokhorov's Pediatrics And Child Neurology Pc · NPI 1104132778
Pediatrics organization in Rego Park, New York. Organization record, active in the CMS NPPES registry since August 20, 2010.
## Identity
- **NPI:** 1104132778 (Entity type: Organization)
- **Enumerated:** August 20, 2010
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **Organization subpart:** No
- **Authorized official:** Svetlana Prokhorova, PRESIDENT
## Practice location
- **Address:** 9817 QUEENS BLVD, LL2, Rego Park, NY 11374-3336
- **Phone:** (718) 275-5600 · **Fax:** (718) 275-5608
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Non-DME Part B, New York, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Neurology (1), Pediatric Medicine (1); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 3, 2011
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Source: [NPI Profile](https://npiprofile.com/npi/1104132778) · Data from the CMS NPPES public registry.