Active NPI
Kathy Elashvili
- Pharmacist
- South Richmond Hill, NY
National Provider Identifier
1922282664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 045676
- Practice address
- 12202 Liberty Ave
South Richmond Hill, NY 11419-2114 - Phone
- (718) 843-7001
- Fax
- (718) 843-4787
- NPI assigned
- Dec 17, 2007
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 045676 | NY | Primary |
Addresses
Primary practice location
12202 Liberty Ave
South Richmond Hill, NY 11419-2114
Mailing address
12202 Liberty Ave
South Richmond Hill, NY 11419-2114
Phone (718) 843-7001
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01562321 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 045676 | NY | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore Chemists LLC | Current | Accepting new patients | |
| Rite Aid of New York Inc | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
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.
-
dba Rite Aid Pharmacy 03733
- Community/Retail Pharmacy
- New York, NY
- NPI 1639288129
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197849600000",
"number": "1922282664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12202 LIBERTY AVE",
"city": "SOUTH RICHMOND HILL",
"state": "NY",
"postal_code": "114192114",
"telephone_number": "718-843-7001",
"fax_number": "718-843-4787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12202 LIBERTY AVE",
"city": "SOUTH RICHMOND HILL",
"state": "NY",
"postal_code": "114192114",
"telephone_number": "718-843-7001",
"fax_number": "718-843-4787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELASHVILI",
"first_name": "KATHY",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-17",
"last_updated": "2007-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "045676",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01562321",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Richmond Hill, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.