Individual provider Active NPI

Anzhela Izrailova, FNP

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1659675320
Registry record updated Jan 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
33 336053 Issued in NY
Practice address
5 E 98TH St FL 6
Department of Anesthesia
New York, NY 10029-6501
Phone
(212) 241-8916
NPI assigned
Jan 10, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 33 336053 NY Primary

Addresses

Primary practice location

5 E 98TH St FL 6
Department of Anesthesia
New York, NY 10029-6501

Mailing address

6536 110TH St
Forest Hills, NY 11375-1845
Phone (646) 691-4353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20210428002803 NY Practitioner - Nurse Practitioner 6103235395 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33 336053NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rd Medical Professional Services PC CurrentSince May 1, 2024 Accepting new patients
SG Medical Professional PC CurrentSince Apr 27, 2025 Accepting new patients

Locations

801 W 190th St
New York, NY 10040
Phone (212) 543-5000

140 Beach 114th St
Rockaway Park, NY 11694
Phone (718) 945-4600

918 James St
Syracuse, NY 13203
Phone (315) 474-1561

612 Corporate Way
Ste 1M
Vly Cottage, NY 10989
Phone (718) 732-3634

Organizations & group practices 2

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": "1294617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294617600000",
    "number": "1659675320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6536 110TH ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751845",
            "telephone_number": "646-691-4353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 E 98TH ST FL 6",
            "address_2": "DEPARTMENT OF ANESTHESIA",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100296501",
            "telephone_number": "212-241-8916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZRAILOVA",
        "first_name": "ANZHELA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-10",
        "last_updated": "2011-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "33 336053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.