Individual provider Active NPI

Erica Lara Rabinovich, DO

  • Pediatric Gastroenterology Physician
  • New Hyde Park, NY
National Provider Identifier
1679032437
Registry record updated May 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
317424-01 Issued in NY
Practice address
1991 Marcus Ave Ste M100
New Hyde Park, NY 11042-2062
Phone
(516) 472-3650
NPI assigned
Mar 19, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0206X 317424-01 NY Primary

Addresses

Primary practice location

1991 Marcus Ave Ste M100
New Hyde Park, NY 11042-2062

Mailing address

4200 Wisconsin Ave NW Ste 4
Washington, DC 20016-2143
Phone (202) 243-3400

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250707003248 NY Practitioner - Pediatric Medicine 9638683238 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
317424-01NYMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore - Lij Medical PC CurrentSince Aug 1, 2025 Accepting new patients
North Shore-Lij Medical PC Single Specialty CurrentSince Aug 1, 2025 Accepting new patients
Wyckoff Professional Medical Services, PC Single Specialty CurrentSince Sep 1, 2025 Accepting new patients

Locations

374 Stockholm St
Brooklyn, NY 11237
Phone (718) 963-6485

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

1991 Marcus Ave
Ste M100
New Hyde Park, NY 11042
Phone (516) 472-3650

300 Community Dr
Plandome, NY 11030

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: ericarabinovich@nslijmedgr.allscriptsdirect.net

Organizations & group practices 3

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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777766400000",
    "number": "1679032437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 WISCONSIN AVE NW STE 4",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200162143",
            "telephone_number": "202-243-3400",
            "fax_number": "202-243-3234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 MARCUS AVE STE M100",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110422062",
            "telephone_number": "516-472-3650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABINOVICH",
        "first_name": "ERICA",
        "middle_name": "LARA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2026-05-03",
        "certification_date": "2026-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "NY",
            "license": "317424-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

Verify at the official NPI Registry.