Individual provider Active NPI

Elnoton Kurayev

  • Adult Health Nurse Practitioner
  • Oakland Gardens, NY
National Provider Identifier
1407406275
Registry record updated Sep 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
309401 Issued in NY
Practice address
7524 Bell Blvd Apt 5a
Oakland Gardens, NY 11364-3418
Phone
(347) 481-7566
NPI assigned
Sep 13, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2019

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 309401 NY Primary

Addresses

Primary practice location

7524 Bell Blvd Apt 5a
Oakland Gardens, NY 11364-3418

Mailing address

7524 Bell Blvd Apt 5a
Oakland Gardens, NY 11364-3418
Phone (347) 481-7566

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
I20191104000100 NY Practitioner - Nurse Practitioner 6103135025 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
309401NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
LR Medical PLLC CurrentSince Oct 1, 2024 Accepting new patients
LR Medical PLLC CurrentSince Oct 1, 2024 Accepting new patients

Locations

300 Old Country Rd
Ste 101
Mineola, NY 11501
Phone (516) 400-2988

260 W Sunrise Hwy
Ste 108
Valley Stream, NY 11581

Organizations & group practices 2

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": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568332800000",
    "number": "1407406275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7524 BELL BLVD APT 5A",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113643418",
            "telephone_number": "347-481-7566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7524 BELL BLVD APT 5A",
            "city": "OAKLAND GARDENS",
            "state": "NY",
            "postal_code": "113643418",
            "telephone_number": "347-481-7566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURAYEV",
        "first_name": "ELNOTON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-13",
        "last_updated": "2019-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "309401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland Gardens, NY

Sources for this page

Verify at the official NPI Registry.