Elina Gavrilova, R-PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

011611 Issued in NY

Practice address

3141 45TH St
Long Island City, NY 11103-1621

Phone

(718) 721-1500

Fax

(718) 777-1623

NPI assigned

Jun 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Networks

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

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.

• Samaritan Medical Services, P.C.

  • Internal Medicine Physician
  • West Islip, NY
  • NPI 1124184544
  Medicare reassignment

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174726095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3141 45TH ST",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111031621",
            "telephone_number": "718-721-1500",
            "fax_number": "718-777-1623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3141 45TH ST",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111031621",
            "telephone_number": "718-721-1500",
            "fax_number": "718-777-1623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVRILOVA",
        "first_name": "ELINA",
        "credential": "R-PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "011611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP TAX ID",
            "identifier": "11-2990594",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Giacoma Rosa Gattuso, REGISTERED NURSE
• Fotini Gatzonis
• Brittany Gautreau, LCSW
• Emy Sanchez Gaviola, RN
• Ma Lizette Gaviola
• Sujoy Gayen
• Karen Geisenheimer
• Edelyn Gelin, LPN
• Jannelle T Gellizeau, RN
• Jamie Genao, RN

• Physician Assistant in Long Island City, NY
• Providers in Long Island City, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.