Organization Active NPI

Irina Nurse Practitioner, LLC.

  • Primary Care Nurse Practitioner
  • Philadelphia, PA
National Provider Identifier
1285581793
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
IRINA NURSE PRACTITIONER, LLC.
Practice address
9867 Bustleton Ave Ste B
Philadelphia, PA 19115-2600
Phone
(267) 516-7746
NPI assigned
Mar 13, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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

Authorized official

Name
Irina EfraimovichNPI 1124348354
Title
Owner
Phone
(267) 516-7746

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

9867 Bustleton Ave Ste B
Philadelphia, PA 19115-2600

Mailing address

9867 Bustleton Ave Ste B
Philadelphia, PA 19115-2600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260505000082 PA Part B Supplier - Clinic/Group Practice 5092283499 Receives reassigned benefits from 1 practitioner
Practice locations: Philadelphia, PA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1773360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773360000000",
    "number": "1285581793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9867 BUSTLETON AVE STE B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191152600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9867 BUSTLETON AVE STE B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191152600",
            "telephone_number": "267-516-7746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRINA NURSE PRACTITIONER, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-13",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A",
        "authorized_official_last_name": "EFRAIMOVICH",
        "authorized_official_first_name": "IRINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "267-516-7746"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.