Individual provider Active NPI

Marina Elnatanova

  • Family Medicine Physician
  • Flushing, NY
National Provider Identifier
1851003727
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
F349268-01 Issued in NY
Practice address
14431 72ND Dr
Flushing, NY 11367-2403
Phone
(917) 318-6876
NPI assigned
Dec 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X F349268-01 NY Primary

Addresses

Primary practice location

14431 72ND Dr
Flushing, NY 11367-2403

Mailing address

14431 72ND Dr
Flushing, NY 11367-2403
Phone (917) 318-6876

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
I20240930000098 NY Practitioner - Nurse Practitioner 1355872565 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F349268-01NYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Me NP in Family Health PLLC CurrentSince Aug 7, 2024 Accepting new patients
Infinite Medical PC Family Medicine CurrentSince Oct 5, 2024 Accepting new patients

Locations

250 Skillman St
Ste 202
Brooklyn, NY 11205

11915 27th Ave
Flushing, NY 11354
Phone (631) 681-4754

99 Madison Ave
Ste 415
New York, NY 10016
Phone (917) 318-6876

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": "1671580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1851003727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14431 72ND DR",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113672403",
            "telephone_number": "917-318-6876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14431 72ND DR",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113672403",
            "telephone_number": "917-318-6876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELNATANOVA",
        "first_name": "MARINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-21",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "F349268-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

Verify at the official NPI Registry.