RONI RAFAILOV
NPI 1184191801
Nurse Practitioner - Family in Forest Hills, NY

Q: What is Roni Rafailov's NPI number?

The NPI number for Roni Rafailov is 1184191801. It was assigned to this individual provider in the NPPES registry on October 31, 2018.

Q: What is Roni Rafailov's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Roni Rafailov was last updated on April 21, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since October 31, 2018PECOS Enrolled

11835 QUEENS BLVD STE 400, FOREST HILLS, NY 11375(646) 722-7610(347) 535-3970 Get Directions Write a Review

NPPES record last updated: April 21, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Roni Rafailov NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RONI RAFAILOV (NPI 1184191801) is an individual family provider in Forest Hills, New York, licensed in New York (343427) and active in the NPI registry since October 2018. He is enrolled in Medicare PECOS, maintains a secondary practice location in Rego Park, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1184191801

Entity TypeIndividualMale

Primary Taxonomy363LF0000X

Provider Legal NameRONI RAFAILOV

Location Address11835 QUEENS BLVD STE 400Forest Hills, NY 11375-7211

Mailing Address9810 64th Ave Apt 4fRego Park, NY 11374-2502 · (718) 864-5734

Phone(646) 722-7610

Fax(347) 535-3970

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateOctober 31, 2018

Last NPPES UpdateApril 21, 2025

NPPES CertifiedApril 21, 2025

✔ NPI 1184191801 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in NY · 343427

11835 QUEENS BLVD STE 400, Forest Hills, NY 11375

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Secondary Practice Location 1

Location 19810 64th Ave Apt 4FRego Park, NY 11374-2502 · Phone (718) 864-5734

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Roni Rafailov is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8820326838

PECOS Enrollment IDI20190828001877

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11375 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$104.17 typical visit price

range $67.00 – $201.98

Typical copayment $26.04 (range $16.75 – $50.49)

Most-billed visit code 99203

Established Patient

$116.96 typical visit price

range $21.62 – $163.52

Typical copayment $29.24 (range $5.40 – $40.88)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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