Individual provider Active NPI

Ravella Jainarain, NP

  • Adult Health Nurse Practitioner
  • Queens Village, NY
National Provider Identifier
1205185444
Registry record updated Sep 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F305457-1 Issued in NY
Practice address
10415 211TH PL
Queens Village, NY 11429-1545
Phone
(917) 224-0216
NPI assigned
Sep 4, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F305457-1 NY Primary

Addresses

Primary practice location

10415 211TH PL
Queens Village, NY 11429-1545

Mailing address

10415 211TH PL
Queens Village, NY 11429-1545
Phone (917) 224-0216

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
I20130913000001 NY Practitioner - Nurse Practitioner 7517101538 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Sinai School of MedicineGroup PAC ID 6406096544, 150 clinicians

Practice addresses (Care Compare)

1 Healthy Way
Oceanside, NY 11572-1551
Phone (516) 632-3670

Hospital & facility affiliations

  • Mount Sinai South Nassau Hospital, Oceanside, NY, CCN 330198

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F305457-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Sinai School of Medicine Current Accepting new patients
Jamaica Hospital CurrentSince Jun 3, 2013 Accepting new patients
Mount Sinai School of Medicine CurrentSince Oct 1, 2019 Accepting new patients
Mount Sinai School of Medicine CurrentSince Oct 1, 2019 Accepting new patients
Jamaica Hospital CurrentSince Jun 3, 2013 Accepting new patients

Locations

1 Healthy Way
Oceanside, NY 11572
Phone (516) 255-1581

13303 Jamaica Ave
Richmond Hill, NY 11418
Phone (718) 206-6942

10 E Merrick Rd
Ste 207
Valley Stream, NY 11580
Phone (516) 256-2017

Networks

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

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 1

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": "1346716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1205185444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10415 211TH PL",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114291545",
            "telephone_number": "917-224-0216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10415 211TH PL",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114291545",
            "telephone_number": "917-224-0216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAINARAIN",
        "first_name": "RAVELLA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-04",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F305457-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queens Village, NY

Sources for this page

Verify at the official NPI Registry.