Individual provider Active NPI

Elena Alekseyevna Ralik, MD

  • Internal Medicine Physician
  • Auburn, CA
National Provider Identifier
1912062811
Registry record updated Dec 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A66778 Issued in CA
Practice address
11583 C Ave
Auburn, CA 95603
Phone
(530) 886-3439
Fax
(530) 889-7276
NPI assigned
Dec 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A66778 CA Primary

Addresses

Primary practice location

11583 C Ave
Auburn, CA 95603

Mailing address

11583 C Ave
Auburn, CA 95603
Phone (530) 886-3439

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091014000189 CA Practitioner - Internal Medicine 4587700042 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
66778CAMDPharmacist
A66778CAMDInternal Medicine Physician

Organizations & group practices 1

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": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1912062811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11583 C AVE",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "95603",
            "telephone_number": "530-886-3439",
            "fax_number": "530-889-7276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11583 C AVE",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "95603",
            "telephone_number": "530-886-3439",
            "fax_number": "530-889-7276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RALIK",
        "first_name": "ELENA",
        "middle_name": "ALEKSEYEVNA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A66778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, CA

Sources for this page

Verify at the official NPI Registry.