Individual provider Active NPI

Rachel Evelkin

  • Specialist
  • Brooklyn, NY
National Provider Identifier
1982479192
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
3929771 Issued in NY
Practice address
39 Exeter St
Brooklyn, NY 11235-3703
Phone
(347) 733-5676
NPI assigned
Nov 17, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 3929771 NY Primary

Addresses

Primary practice location

39 Exeter St
Brooklyn, NY 11235-3703

Mailing address

39 Exeter St
Brooklyn, NY 11235-3703

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3929771NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1700179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1982479192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 EXETER ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 EXETER ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353703",
            "telephone_number": "347-733-5676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVELKIN",
        "first_name": "RACHEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-17",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "3929771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; 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.