Revathi Nair-Raghavan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

019039 Issued in NY

Practice address

111 East 210TH Street
Ground Floor, Gold Zone
Bronx, NY 10467-2940

Phone

(718) 920-5440

Fax

(718) 863-5763

NPI assigned

Oct 9, 2015

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

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

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

May accept Medicare assignment

Group practices

Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: renai@montefioredirect.com
• Direct secure messaging: ren9019@direct.nyp.org

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.

• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152
  Medicare reassignment Care Compare group NPD
• Montefiore Medical Center

  • Community/Retail Pharmacy
  • Bronx, NY
  • NPI 1194183715
  NPD

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

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1710358296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 EAST 210TH STREET",
            "address_2": "GROUND FLOOR, GOLD ZONE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672940",
            "telephone_number": "718-920-5440",
            "fax_number": "718-863-5763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 EAST 210TH STREET",
            "address_2": "GROUND FLOOR, GOLD ZONE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672940",
            "telephone_number": "718-920-5440",
            "fax_number": "718-863-5763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIR-RAGHAVAN",
        "first_name": "REVATHI",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-09",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shadi Nahvi, MD
• Amisha Naik, PA-C
• Manali K Naik
• Leah Liora Naim, FNP
• Khaschayar Nik Nainzadeh, M.D.
• Anirudh Nair
• Anita Nair
• Nita Jayakumar Nair, M.D.
• Rahul Nair, M.D.
• Revathi Nair

• Physician Assistant in Bronx, NY
• Providers in Bronx, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.