Individual provider Active NPI

Inna R Raykhelgauz, FNP

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1306103122
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F336419 Issued in NY
Practice address
394 Broadway FL 4
New York, NY 10013-6023
Phone
(212) 966-9537
NPI assigned
Apr 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F336419 NY Primary

Addresses

Primary practice location

394 Broadway FL 4
New York, NY 10013-6023

Mailing address

501 Surf Ave
Apt. 22B
Brooklyn, NY 11224-3551

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
I20131018000007 NY Practitioner - Nurse Practitioner 7911131362 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F336419NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
United Cerebral Palsy of New York City Inc CurrentSince Nov 1, 2022 Accepting new patients
Hollis Ak LLC CurrentSince Jan 2, 2024 Accepting new patients
Eastern Physical Medicine and Rehabilitation PC PastSince Jan 2, 2024 Accepting new patients

Locations

175 Lawrence Ave
Brooklyn, NY 11230
Phone (718) 436-7600

80 Maiden Ln
Fl 12
New York, NY 10038

Interoperability endpoints

  • Direct secure messaging: iraykhelgauz1284850@nychhc.direct-ci.com
  • Direct secure messaging: inna.raykhelgauz.1@24989.direct.athenahealth.com
  • Direct secure messaging: inna.raykhelgauza.p1@direct.ucpnyc.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1306103122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 SURF AVE",
            "address_2": "APT. 22B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112243551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "394 BROADWAY FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100136023",
            "telephone_number": "212-966-9537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYKHELGAUZ",
        "first_name": "INNA",
        "middle_name": "R",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-18",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F336419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.