Rafie Davidov, A.P.N.-C.N.P.

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

209014789 Issued in IL

Practice address

800 Biesterfield Rd Ste G01
Wimmer Building
Elk Grove Village, IL 60007-3372

Phone

(847) 981-3680

Fax

(847) 956-5122

NPI assigned

Nov 11, 2016

Last updated

Nov 11, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Rafie Dzhudzho Former name

Medicare fee-for-service enrollment

Enrolled in IL

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 1

Specialty

Nurse Practitioner

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alexian Brothers Specialty GroupGroup PAC ID 0840465084, 45 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Alexian Brothers Medical Center 1 Hospital, Elk Grove Village, IL, CCN 140258
• St Alexius Medical Center Hospital, Hoffman Estates, IL, CCN 140290

Merit-based Incentive Payment System (MIPS)

Final score

89.9 of 100Reported as group

Quality

72.65

Promoting interoperability

98

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rafie.davidov.p1@direct.cmi.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alexian Brothers Specialty Group

  • Specialist
  • Elk Grove Village, IL
  • NPI 1720371669
  Medicare reassignment Care Compare group NPD
• Cardiovascular Associates, S.C.

  • Cardiovascular Disease Physician
  • Elk Grove Village, IL
  • NPI 1740231505
  NPD (past)
• West Suburban Cardiologists, LTD.

  dba Heart and Vascular of Illinois

  • Cardiovascular Disease Physician
  • Chicago, IL
  • NPI 1316998578
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Alexian Brothers Medical Center

  • General Acute Care Hospital
  • Elk Grove Village, IL
  • NPI 1265577191
  Care Compare affiliation
• St. Alexius Medical Center

  • General Acute Care Hospital
  • Hoffman Estates, IL
  • NPI 1376644385
  Care Compare affiliation

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

{
    "created_epoch": "1478822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478822400000",
    "number": "1649712373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S FRONTAGE RD",
            "address_2": "SUITE 325",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605174903",
            "telephone_number": "630-972-8228",
            "fax_number": "630-972-8229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD STE G01",
            "address_2": "WIMMER BUILDING",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073372",
            "telephone_number": "847-981-3680",
            "fax_number": "847-956-5122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDOV",
        "first_name": "RAFIE",
        "credential": "A.P.N.-C.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-11",
        "last_updated": "2016-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209014789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PRACTICE NPI",
            "identifier": "1720371669",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAFIE",
            "last_name": "DZHUDZHO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Carole Dankers, LCPC
• Ankur Dave, MD
• Reena Dave, MSN, FNP-BC
• Christina Davenport, APN
• David J Schumer DDS PC
• Amy Davis, PHD
• Brittany Davis
• Derrek Davis, M.D.
• Jennifer Erin Davis, MSPT
• Raymond Edwin Davis

• Gerontology Nurse Practitioner in Elk Grove Village, IL
• Providers in Elk Grove Village, IL by specialty
• Gerontology Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.