Reava Khristenko, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN2306581 Issued in MA

Practice address

150 S Huntington Ave
Boston, MA 02130-4817

Phone

(617) 232-9500

NPI assigned

Nov 25, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Nesc Macipa LLCGroup PAC ID 2062659071, 3 clinicians

Dermcare Physicians and Surgeons LLCGroup PAC ID 9234141904, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Dermcare Physicians and Surgeons LLC

  • Dermatology Physician
  • Natick, MA
  • NPI 1780636597
  Medicare reassignment Care Compare group NPD
• Nesc Macipa LLC

  • MOHS-Micrographic Surgery Physician
  • Arlington, MA
  • NPI 1467791665

  Dermatology

  Medicare reassignment Care Compare group NPD
• Nesc Bidpo LLC

  • MOHS-Micrographic Surgery Physician
  • Natick, MA
  • NPI 1235478595

  Dermatology

  Medicare reassignment NPD
• Nesc Steward, LLC

  • MOHS-Micrographic Surgery Physician
  • Natick, MA
  • NPI 1538575386
  Medicare reassignment NPD
• Nesc Lpho LLC

  • MOHS-Micrographic Surgery Physician
  • Natick, MA
  • NPI 1215276415
  NPD

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

{
    "created_epoch": "1511568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511568000000",
    "number": "1093229379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 SOUTH ST",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024673630",
            "telephone_number": "617-921-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S HUNTINGTON AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021304817",
            "telephone_number": "617-232-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHRISTENKO",
        "first_name": "REAVA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-25",
        "last_updated": "2017-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "RN2306581",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "MA",
            "license": "RN2306581",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2306581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Noor Khouqeer
• Sandra A Khouri
• Rasha S. Khoury, M.D.
• Sarah Khoury
• Shirin Khoynezhad, DDS
• Jasmine A. Khubchandani, MD
• Fay Khudairi
• Jana Khudr
• Rohit Khullar, MD
• Sara Khundkar, MD

• Nurse Practitioner in Boston, MA
• Providers in Boston, MA by specialty
• Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2017; 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.