Rena Kavian, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

017238 Issued in NY

Practice address

1577 E 21St St
Brooklyn, NY 11210-5049

Phone

(347) 403-6922

NPI assigned

Dec 4, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: rdavatgarzadeh9632@nychhc.direct-ci.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1386115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552521600000",
    "number": "1922439744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1577 E 21ST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112105049",
            "telephone_number": "347-403-6922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1577 E 21ST ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112105049",
            "telephone_number": "347-403-6922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVIAN",
        "first_name": "RENA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-04",
        "last_updated": "2019-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "392353606",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Kavanagh, M.D.
• Grace K Kavanah, RN
• Brendan Tyrone Kavanaugh, LSW
• Vaishnavi Kaveeshwar, PT
• Eliyahu Kavian, PA-C
• Naomi Kavka
• Beka Kavtaradze, LMSW
• Srinivas Rao Kavuri, BS
• Swathi Kavuri, MD
• Vimal Kavuru, RPH

• Physician Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.