Individual provider Active NPI

Irina Kalantarova, PA

  • Medical Physician Assistant
  • Forest Hills, NY
National Provider Identifier
1104866557
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
008566 Issued in NY
Practice address
7035 113TH St
Forest Hills, NY 11375-4651
Phone
(718) 990-4648
Fax
(718) 990-4414
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 008566 NY Primary

Addresses

Primary practice location

7035 113TH St
Forest Hills, NY 11375-4651

Mailing address

PO Box 1471
Buffalo, NY 14240-1471
Phone (800) 795-5820

Other identifiers 2

IdentifierTypeStateIssuer
P00392222OtherNYRAILROAD
P00403315OtherNYRAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20050214000116 NY Practitioner - Physician Assistant 6002868528 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeco Medical, P.C. Past Accepting new patients
Harlem Medical Associates PC Past Accepting new patients
New York City Health and Hospitals Corporation Past Accepting new patients
The Parkway Hospital Past Accepting new patients

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194998400000",
    "number": "1104866557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1471",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142401471",
            "telephone_number": "800-795-5820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7035 113TH ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113754651",
            "telephone_number": "718-990-4648",
            "fax_number": "718-990-4414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALANTAROVA",
        "first_name": "IRINA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2007-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "008566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00392222",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00403315",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.