Hellena Rafailov, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

013910-1 Issued in NY

Practice address

1050 Clove Rd
Staten Island, NY 10301-3627

Phone

(718) 816-6440

Fax

(718) 816-3115

NPI assigned

Apr 13, 2010

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hrafailov69775@northwell.direct-ci.com
• Direct secure messaging: hellena.rafailov@ghuc.eclinicaldirectplus.com

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.

• Origin Pain Management and Medical Care, PLLC

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Brooklyn, NY
  • NPI 1871771402
  NPD
• Staten Island Physician Practice PC

  • Internal Medicine Physician
  • New York, NY
  • NPI 1568413169
  NPD (past)

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

{
    "created_epoch": "1271116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449532800000",
    "number": "1972829133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 9TH AVE",
            "address_2": "CREDENTIALING 3RD FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100011623",
            "telephone_number": "646-680-2894",
            "fax_number": "516-542-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 CLOVE RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103013627",
            "telephone_number": "718-816-6440",
            "fax_number": "718-816-3115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAFAILOV",
        "first_name": "HELLENA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-13",
        "last_updated": "2015-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "013910-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03555653",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Radiology Services of New York, PC
• Miriam Radov, O.D.
• Raduga, Inc.
• Elina Radushinsky, L.AC
• Agnes Radzio, MD
• Yuriy Rafailov, DOCTORATE
• Amgad Ahmed Ragab, PHARMACIST
• Emma Catherine Raggio, OTD, OTR/L
• Roland J Raggio
• Khadiga Hassan Ragheb

• Physician Assistant in Staten Island, NY
• Providers in Staten Island, 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 Dec 8, 2015; 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.