Individual provider Active NPI

Elnora Khodjaeva, FNP

  • Family Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1851916688
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F345093-01 Issued in NY
Practice address
221 Parkville Ave
#1
Brooklyn, NY 11230
Phone
(718) 676-0111
NPI assigned
Jun 8, 2020
Last updated
Jun 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F345093-01 NY Primary

Addresses

Primary practice location

221 Parkville Ave
#1
Brooklyn, NY 11230

Mailing address

3086 West 1St Street
Aptr4
Brooklyn, NY 11224-3708
Phone (347) 972-4138

Other practice location 1

3086 West 1st street
AptR4
Brooklyn, NY 11224-3708
Phone (347) 972-4138

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
I20210202001753 NY Practitioner - Nurse Practitioner 5991119927 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
B and L Health IncGroup PAC ID 9830124908, 26 clinicians

Practice addresses (Care Compare)

1655 E 13TH St
Brooklyn, NY 11229-1101
Phone (718) 339-6300

Merit-based Incentive Payment System (MIPS)

Final score
22.62 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
75.38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F345093-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
B & L Health Inc CurrentSince May 15, 2024 Accepting new patients
Easy Care Medical Services P.C. CurrentSince Oct 15, 2024 Accepting new patients
B&L Health Inc. Dba Allhealth Diagnostic and Treatment Center Past Accepting new patients

Locations

1100 Coney Island Ave
Ste 2
Brooklyn, NY 11230
Phone (718) 434-2100

1655 E 13th St
Brooklyn, NY 11229
Phone (718) 339-3100

1840 E 14th St
Brooklyn, NY 11229
Phone (347) 286-1383

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BJEBCD

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, 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": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1851916688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3086 WEST 1ST STREET",
            "address_2": "APTR4",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112243708",
            "telephone_number": "347-972-4138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 PARKVILLE AVE",
            "address_2": "#1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11230",
            "telephone_number": "718-676-0111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3086 West 1st street",
            "address_2": "AptR4",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112243708",
            "country_code": "US",
            "telephone_number": "347-972-4138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHODJAEVA",
        "first_name": "ELNORA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-08",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F345093-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.