Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nikolay Tarkhanov, MD

Individual provider Family Medicine Physician · NPI 1487782629

Nikolay Tarkhanov, MD is a Family Practice in Staten Island, New York. Qualified in 1979, 47 years ago. Practices with Calvary Hospital Inc, a 50-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
47
Licensed in
NY
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

15 Rome Ave
Staten Island, NY 10304-4317
Phone: (718) 816-0740
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 243184 (NY)

Record details

NPI number1487782629
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 1, 2007
Last updated in NPPESSeptember 8, 2008

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 1979 (47 years in practice)
Group practice Calvary Hospital Inc — 50 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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