Individual provider Active NPI

Rachel Lise Ciota, FNP

  • Family Nurse Practitioner
  • Long Island City, NY
National Provider Identifier
1366996407
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
345263 Issued in NY
Practice address
4610 Center Blvd Apt 2111
Long Island City, NY 11109-5882
Phone
(631) 456-1130
NPI assigned
Aug 5, 2016
Last updated
Apr 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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 345263 NY Primary

Addresses

Primary practice location

4610 Center Blvd Apt 2111
Long Island City, NY 11109-5882

Mailing address

4610 Center Blvd Apt 2111
Long Island City, NY 11109-5882
Phone (631) 456-1130

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
I20200302001606 NY Practitioner - Nurse Practitioner 4981990173 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jul 1, 2024 Accepting new patients
New York University CurrentSince Jul 1, 2024 Accepting new patients
Divinity Medical Services PLLC CurrentSince Sep 20, 2022 Accepting new patients
Mobile Medical Healthcare, P.C. CurrentSince Sep 1, 2025 Accepting new patients

Locations

700 Hicksville Rd
Ste 205
Bethpage, NY 11714
Phone (646) 501-3325

5546 Broadway
Bronx, NY 10463
Phone (917) 383-2164

35 W 35th St
Fl 4
New York, NY 10001
Phone (844) 553-6246

685 3rd Ave
Fl 9
New York, NY 10017
Phone (212) 273-9770

3379 Crompond Rd
Yorktown Hts, NY 10598
Phone (914) 245-1111

Interoperability endpoints

  • Direct secure messaging: rachel.ciota.1@24989.direct.athenahealth.com

Organizations & group practices 4

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": "1470355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1366996407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4610 CENTER BLVD APT 2111",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111095882",
            "telephone_number": "631-456-1130",
            "fax_number": "718-684-5266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4610 CENTER BLVD APT 2111",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111095882",
            "telephone_number": "631-456-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIOTA",
        "first_name": "RACHEL",
        "middle_name": "LISE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-05",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "345263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

Verify at the official NPI Registry.