Individual provider Active NPI

Natalia Bolkvadze

  • Registered Nurse
  • Brooklyn, NY
National Provider Identifier
1487347068
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
343199 Issued in NY
Practice address
3380 Nostrand Ave
Brooklyn, NY 11229-4056
Phone
(347) 424-7310
NPI assigned
May 31, 2023
Last updated
May 31, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 343199 NY Primary

Addresses

Primary practice location

3380 Nostrand Ave
Brooklyn, NY 11229-4056

Mailing address

3380 Nostrand Ave
Brooklyn, NY 11229-4056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
343199NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1685491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1487347068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3380 NOSTRAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3380 NOSTRAND AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112294056",
            "telephone_number": "347-424-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLKVADZE",
        "first_name": "NATALIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-31",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "343199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.