Individual provider Active NPI

Eliyahu Kavian, PA-C

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1699183467
Registry record updated Mar 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
017732 Issued in NY
Practice address
432 Bedford Ave
Brooklyn, NY 11249-6588
Phone
(718) 387-2408
NPI assigned
Jul 24, 2014
Last updated
Mar 2, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 017732 NY Primary

Addresses

Primary practice location

432 Bedford Ave
Brooklyn, NY 11249-6588

Mailing address

432 Bedford Ave
Brooklyn, NY 11249-6588
Phone (718) 387-2408

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
I20150304000822 NY Practitioner - Physician Assistant 8123344413 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
017732NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Fpa Hospital Based CurrentSince Aug 1, 2014 Accepting new patients
Fpa Hospital Based CurrentSince Aug 1, 2014 Accepting new patients
Oda Primary Health Care Network, Inc. Past Accepting new patients
Bimc Faculty Practice Physician Assistant Past Accepting new patients
Slrhc Faculty Practice Past Accepting new patients
Oda Primary Health Care Network, Inc. Past Accepting new patients
St Lukes Roosevelt Hospital Center Past Accepting new patients

Locations

1000 10th Ave
New York, NY 10019
Phone (212) 523-2369

Networks

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

Interoperability endpoints

  • Direct secure messaging: eliyahu.kavian@oda.eclinicaldirectplus.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1406160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488412800000",
    "number": "1699183467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 BEDFORD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112496588",
            "telephone_number": "718-387-2408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 BEDFORD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112496588",
            "telephone_number": "718-387-2408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVIAN",
        "first_name": "ELIYAHU",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-24",
        "last_updated": "2017-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.