Rafael Enukashvili, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MA064386 Issued in NJ

Practice address

21 Kilmer Drive
BLDG 2 Suite C
Morganville, NJ 07751-1568

Phone

(732) 617-2988

Fax

(732) 617-2987

NPI assigned

Jun 10, 2006

Last updated

Nov 2, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal MedicineAlso: Geriatric Medicine

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Salerno Medical Associates, LLC

  dba Prospect Spine and Pain

  • Internal Medicine Physician
  • East Orange, NJ
  • NPI 1184766107
  NPD
• Meadowlands Physicians Professional Association

  • General Practice Physician
  • Secaucus, NJ
  • NPI 1669728283
  NPD (past)
• Pain Medicine and Anesthesia PC

  • Pain Medicine (Anesthesiology) Physician
  • Franklin Lakes, NJ
  • NPI 1386925394
  NPD (past)

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193961600000",
    "number": "1073554838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 KILMER DRIVE",
            "address_2": "BLDG 2 SUITE C",
            "city": "MORGANVILLE",
            "state": "NJ",
            "postal_code": "077511568",
            "telephone_number": "732-617-2988",
            "fax_number": "732-617-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 KILMER DRIVE",
            "address_2": "BLDG 2 SUITE C",
            "city": "MORGANVILLE",
            "state": "NJ",
            "postal_code": "077511568",
            "telephone_number": "732-617-2988",
            "fax_number": "732-617-2987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENUKASHVILI",
        "first_name": "RAFAEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2007-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA064386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8651108",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2017306",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P1123503",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emergent Therapeutics LLC
• Empowerment Center
• Empowerment Center Group LLC
• Empowerment Center LLC
• Empyre Wellness
• Paul Erian, DC
• Euro Ambulance of Mexico
• Calli Evans, PT, DPT, LAT, ATC
• Everas Community Services, Inc.
• Facial Imaging of NJ

• Internal Medicine Physician in Morganville, NJ
• Providers in Morganville, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.