Active NPI
Xian Kapetanakos
- Clinical Social Worker
- Queens Village, NY
National Provider Identifier
1255840443
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 089775
- Practice address
- 7925 Winchester Blvd
Queens Village, NY 11427-2128 - Phone
- (718) 464-7500
- NPI assigned
- Sep 20, 2017
- Last updated
- Jul 16, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 089775 | NY | Primary |
Addresses
Primary practice location
7925 Winchester Blvd
Queens Village, NY 11427-2128
Mailing address
7925 Winchester Blvd
Queens Village, NY 11427-2128
Other practice location 1
274 Madison Ave Rm 1501
New York, NY 10016-0701
Phone (212) 203-1773
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 089775 | NY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rivia Medical PLLC | Current | Accepting new patients |
Locations
274 Madison Ave
Rm 1501
New York, NY 10016
Phone (212) 202-1773
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752624000000",
"number": "1255840443",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7925 WINCHESTER BLVD",
"city": "QUEENS VILLAGE",
"state": "NY",
"postal_code": "114272128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7925 WINCHESTER BLVD",
"city": "QUEENS VILLAGE",
"state": "NY",
"postal_code": "114272128",
"telephone_number": "718-464-7500"
}
],
"practiceLocations": [
{
"address_1": "274 Madison Ave Rm 1501",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100160701",
"country_code": "US",
"telephone_number": "212-203-1773",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KAPETANAKOS",
"first_name": "XIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-20",
"last_updated": "2025-07-16",
"certification_date": "2025-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "089775",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Queens Village, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; 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.