Active NPI
Rivka Fuzailov
- Family Nurse Practitioner
- Flushing, NY
National Provider Identifier
1801650320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 353504
- Practice address
- 13708 71St Ave
Flushing, NY 11367-1939 - Phone
- (718) 350-6777
- NPI assigned
- Feb 6, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 353504 | NY | Primary |
Addresses
Primary practice location
13708 71St Ave
Flushing, NY 11367-1939
Mailing address
13708 71St Ave
Flushing, NY 11367-1939
Phone (718) 350-6777
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260306002387 | NY | Order and Referring Only - Nurse Practitioner | 0840772919 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 353504 | NY | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707177600000",
"number": "1801650320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13708 71ST AVE",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113671939",
"telephone_number": "718-350-6777"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13708 71ST AVE",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113671939",
"telephone_number": "718-350-6777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUZAILOV",
"first_name": "RIVKA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-06",
"last_updated": "2024-02-06",
"certification_date": "2024-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "353504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.