Individual provider Active NPI

Ilona Rabinovich, FNP

  • Family Nurse Practitioner
  • Staten Island, NY
National Provider Identifier
1114539368
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
346390 Issued in NY
Practice address
2043 Richmond Ave
Staten Island, NY 10314-3936
Phone
(718) 710-4906
NPI assigned
Aug 19, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 706816-1 NY
Family Nurse Practitioner 363LF0000X 346390 NY Primary

Addresses

Primary practice location

2043 Richmond Ave
Staten Island, NY 10314-3936

Mailing address

6 Arbor CT
Manalapan, NJ 07726-2859
Phone (917) 972-4170

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
I20201129000019 NY Practitioner - Nurse Practitioner 0941611875 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Triborough Gi PLLCGroup PAC ID 2466761531, 15 clinicians

Practice addresses (Care Compare)

1672 Sheepshead Bay Rd
Brooklyn, NY 11235-3803
Phone (718) 332-0600

2043 Richmond Ave
Staten Island, NY 10314-3936
Phone (718) 332-0600

Hospital & facility affiliations

  • Prime Home Health Services, LLC Home health agency, Brooklyn, NY, CCN 337190
  • Girling Health Care of New York Home health agency, Brooklyn, NY, CCN 337243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
706816-1NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Columbia University in the City of New York CurrentSince Dec 26, 2020 Accepting new patients
Trustees of Columbia University in the City of New York Current Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Dec 26, 2020 Accepting new patients
Triborough Gi PLLC CurrentSince Jan 11, 2023 Accepting new patients
Triborough Gi PLLC CurrentSince Jan 11, 2023 Accepting new patients

Locations

1517 Voorhies Ave
Brooklyn, NY 11235
Phone (718) 368-1666

1672 Sheepshead Bay Rd
Brooklyn, NY 11235
Phone (718) 795-2734

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

2043 Richmond Ave
Staten Island, NY 10314
Phone (718) 710-4906

Networks

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

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1114539368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 ARBOR CT",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077262859",
            "telephone_number": "917-972-4170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2043 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143936",
            "telephone_number": "718-710-4906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABINOVICH",
        "first_name": "ILONA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-19",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "706816-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "346390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.