Active NPI
Rafael Robenov, RPA-C
- Medical Physician Assistant
- Jamaica, NY
National Provider Identifier
1003290727
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 018724
- Practice address
- 84-42 151St Street
Jamaica, NY 11432 - Phone
- (718) 350-6252
- NPI assigned
- Jul 13, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 018724 | NY | Primary |
Addresses
Primary practice location
84-42 151St Street
Jamaica, NY 11432
Mailing address
8442 151St St
Jamaica, NY 11432-1618
Phone (718) 350-6252
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018724 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436745600000",
"number": "1003290727",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8442 151ST ST",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114321618",
"telephone_number": "718-350-6252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "84-42 151ST STREET",
"city": "JAMAICA",
"state": "NY",
"postal_code": "11432",
"telephone_number": "718-350-6252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBENOV",
"first_name": "RAFAEL",
"credential": "RPA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-07-13",
"last_updated": "2015-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NY",
"license": "018724",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.