Individual provider Active NPI

Raquel Urbach, PA

  • Medical Physician Assistant
  • Long Island City, NY
National Provider Identifier
1558852897
Registry record updated May 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
022022 Issued in NY
Practice address
2510 30TH Ave
Long Island City, NY 11102-2418
Phone
(718) 932-1000
NPI assigned
May 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 022022 NY Primary

Addresses

Primary practice location

2510 30TH Ave
Long Island City, NY 11102-2418

Mailing address

4815 11TH Ave
Brooklyn, NY 11219-2932
Phone (347) 729-4151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181113001800 NY Practitioner - Physician Assistant 6800140732 Reassigns benefits to 1 organization
I20231122001687 FL Practitioner - Physician Assistant 6800140732

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
022022NYMDOccupational Therapist

Organizations & group practices 1

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": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1558852897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4815 11TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192932",
            "telephone_number": "347-729-4151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 30TH AVE",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111022418",
            "telephone_number": "718-932-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URBACH",
        "first_name": "RAQUEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-22",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "022022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

Verify at the official NPI Registry.