Individual provider Active NPI

Elena Reitman-Ivashkov, M.D.

  • Anesthesiology Physician
  • New York, NY
National Provider Identifier
1457586703
Registry record updated Jul 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
243639 Issued in NY
Practice address
622 W 168TH St
New York, NY 10032-3720
Phone
(212) 305-9878
Fax
(212) 305-8980
NPI assigned
May 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 243639 NY Primary

Addresses

Primary practice location

622 W 168TH St
New York, NY 10032-3720

Mailing address

622 W 168TH St
New York, NY 10032-3720
Phone (212) 305-9878

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110808000308 NY Practitioner - Anesthesiology 8729257860 Reassigns benefits to 2 organizations
I20210201001229 NJ Practitioner - Anesthesiology 8729257860 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
243639NYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Ambulatory Anesthesia, LLC Anesthesiology CurrentSince Jul 25, 2021 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Aug 1, 2018 Accepting new patients
Trustees of Columbia University in the City of New York CurrentSince Aug 1, 2018 Accepting new patients
Trustees of Columbia University in the City of New York Anesthesiology CurrentSince Aug 15, 2011 Accepting new patients
Maywood Anesthesia Consultants LLC CurrentSince Jan 1, 2021 Accepting new patients

Locations

113 W Essex St
Ste 201
Maywood, NJ 07607
Phone (201) 226-0145

6 Chestnut Ridge Rd
Montvale, NJ 07645
Phone (201) 391-4700

525 Union Blvd
Totowa, NJ 07512
Phone (862) 229-0559

1176 Hamburg Tpke
Wayne, NJ 07470
Phone (973) 283-0002

622 W 168th St
New York, NY 10032
Phone (212) 305-4931

622 W 168th St
Ph 5505
New York, NY 10032
Phone (212) 305-6494

161 Fort Washington Ave
New York, NY 10032
Phone (212) 305-8559

Interoperability endpoints

  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/R4/
  • FHIR API: https://epicproxy-pub.et1089.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 5

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": "1242345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311897600000",
    "number": "1457586703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-305-9878",
            "fax_number": "212-305-8980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W 168TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323720",
            "telephone_number": "212-305-9878",
            "fax_number": "212-305-8980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REITMAN-IVASHKOV",
        "first_name": "ELENA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-15",
        "last_updated": "2011-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "243639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.