Organization Active NPI

First Ave Pharm RX, LLC

  • Community/Retail Pharmacy
  • New York, NY
National Provider Identifier
1629960067
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
FIRST AVE PHARM RX, LLC
Doing business as
FIRST AVENUE PHARMACY
Practice address
1765 1St Ave
New York, NY 10128-5276
Phone
(212) 970-1765
Fax
(212) 970-1766
NPI assigned
Jul 18, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Authorized official

Name
Ilya LevyNPI 1467820050
Title
President
Phone
(212) 970-1765

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1765 1St Ave
New York, NY 10128-5276

Mailing address

1765 1St Ave
New York, NY 10128-5276
Phone (212) 970-1765

Other names 1

  • FIRST AVENUE PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20251118002831 NY DME Supplier - Pharmacy 0345731261 Practice locations: New York, NY
O20251218001444 NY Part B Supplier - Pharmacy 0345731261 Practice locations: New York, NY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
First Ave Pharm RX, LLC1765 1St Ave, New York, NY 10128-5276(212) 970-1765 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Nov 18, 2025

National Provider Directory

National Provider Directory

Locations

1765 1st Ave
New York, NY 10128
Phone (212) 970-1765

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1752796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752796800000",
    "number": "1629960067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1765 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101285276",
            "telephone_number": "212-970-1765",
            "fax_number": "212-970-1766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1765 1ST AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101285276",
            "telephone_number": "212-970-1765",
            "fax_number": "212-970-1766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST AVE PHARM RX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-18",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A",
        "authorized_official_last_name": "LEVY",
        "authorized_official_first_name": "ILYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-970-1765"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FIRST AVENUE PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.