Individual provider Active NPI

Irina E Rakhmanina, MD

  • Internal Medicine Physician
  • Port St Lucie, FL
National Provider Identifier
1639109671
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME157323 Issued in FL
Practice address
10650 SW Tradition Pkwy
Port St Lucie, FL 34987-2862
Phone
(772) 241-6840
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME157323 FL Primary

Addresses

Primary practice location

10650 SW Tradition Pkwy
Port St Lucie, FL 34987-2862

Mailing address

10650 SW Tradition Pkwy
Port St Lucie, FL 34987-2862
Phone (772) 241-6840

Other identifiers 2

IdentifierTypeStateIssuer
D56668MedicaidMD
D56668OtherMDLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20221026001865 FL Practitioner - Internal Medicine 4385819028 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD Now Medical Centers IncGroup PAC ID 3971554825, 314 clinicians

Practice addresses (Care Compare)

640 21St St
Vero Beach, FL 32960-0933
Phone (772) 299-1092

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MD Now Medical Centers Inc CurrentSince Mar 24, 2024 Accepting new patients
Orlando Carenow Urgent Care LLC CurrentSince Apr 21, 2024 Accepting new patients
MD Now Medical Centers Inc CurrentSince Feb 1, 2023 Accepting new patients
Crescent Urgent Health Care Services LLC PastSince Dec 18, 2013 Accepting new patients
Hospital Physician Services, LLLP Internal Medicine Past Accepting new patients

Locations

628 Cagan View Rd
Clermont, FL 34714
Phone (352) 242-1988

4570 Lantana Rd
Lake Worth, FL 33463
Phone (305) 949-4141

10650 SW Tradition Pkwy
Port St Lucie, FL 34987
Phone (772) 241-6840

4007 SW Port St Lucie Blvd
Port St Lucie, FL 34953
Phone (772) 343-1774

1900 SE Port St Lucie Blvd
Port St Lucie, FL 34952
Phone (772) 398-1588

5102 Sr 46
Sanford, FL 32771
Phone (321) 765-6152

640 21st St
Vero Beach, FL 32960
Phone (772) 299-1092

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1639109671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10650 SW TRADITION PKWY",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872862",
            "telephone_number": "772-241-6840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10650 SW TRADITION PKWY",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872862",
            "telephone_number": "772-241-6840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAKHMANINA",
        "first_name": "IRINA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME157323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D56668",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "D56668",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.