RAVEN CUSTALOW AGPCNP-BC
NPI 1669955019
Nurse Practitioner - Primary Care in Aylett, VA

Active since September 12, 2018PECOS EnrolledAccepts Medicare Assignment
7864 RICHMOND TAPPAHANNOCK HWY, AYLETT, VA 23009(804) 769-2015 Get Directions Write a Review

NPPES record last updated: November 8, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 8, 2024, Nov 17, 2023, May 5, 2022 and 1 more (4 updates tracked since 2018).

About Raven Custalow Agpcnp-bc NPPES

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

RAVEN CUSTALOW AGPCNP-BC (NPI 1669955019) is an individual primary care provider in Aylett, Virginia, licensed in Virginia (0024176579) and active in the NPI registry since September 2018. She is enrolled in Medicare PECOS, is affiliated with Bon Secours Memorial Regional Medical Center, and is a graduate of Georgetown University School Of Medicine (2018).

NPPES Registry Identity

NPI1669955019
Entity TypeIndividualFemale
Primary Taxonomy363LP2300X
Provider Legal NameRAVEN CUSTALOWCredential: AGPCNP-BC
Location Address7864 RICHMOND TAPPAHANNOCK HWYAylett, VA 23009-3056
Mailing Address3944 Upshaw RdAylett, VA 23009-2912 · (804) 928-8477
Sole ProprietorNo
Medical School CMSGeorgetown University School Of MedicineGraduated 2018
Enumeration DateSeptember 12, 2018
Last NPPES UpdateNovember 8, 20244 updates tracked since enumeration
NPPES CertifiedNovember 8, 2024
NPI 1669955019 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License Licensed in VA · 0024176579
7864 RICHMOND TAPPAHANNOCK HWY, Aylett, VA 23009

Other Identifiers 1

Medicaid3001529971VA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Raven Custalow Agpcnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID840543013
PECOS Enrollment IDI20241104002126
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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
14 services14 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Bon Secours Memorial Regional Medical Center

Acute Care Hospitals · Mechanicsville, VA
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number490069
Location8260 Atlee RoadMechanicsville, VA 23116 · Hanover County
Emergency services Birthing friendly

Vcu Health Tappahannock Hospital

Acute Care Hospitals · Tappahannock, VA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490084
Location618 Hospital RoadTappahannock, VA 22560 · Essex County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23009 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
$86.88 typical visit price
range $56.19 – $170.30
Typical copayment $21.72 (range $14.04 – $42.57)
Most-billed visit code 99203
Established Patient
$99.13 typical visit price
range $18.07 – $138.91
Typical copayment $24.78 (range $4.51 – $34.72)
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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
1 supplier12 claims12 services$103.87 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
7864 RICHMOND TAPPAHANNOCK HWY
AYLETT, VA 23009
Social Worker (Clinical)
7864 RICHMOND TAPPAHANNOCK HWY
AYLETT, VA 23009
Clinical Medical Laboratory
7864 RICHMOND TAPPAHANNOCK HWY
AYLETT, VA 23009
Family Medicine
7864 RICHMOND TAPPAHANNOCK HWY
AYLETT, VA 23009
Family Medicine
7864 RICHMOND TAPPAHANNOCK HWY
AYLETT, VA 23009
Pharmacist
7864 RICHMOND TAPPAHANNOCK HWY
AYLETT, VA 23009
Family Medicine
7864 RICHMOND TAPPAHANNOCK HWY
AYLETT, VA 23009
Family Medicine
7864 RICHMOND TAPPAHANNOCK HWY
AYLETT, VA 23009

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Raven Custalow's NPI number?

The NPI number for Raven Custalow is 1669955019. It was assigned to this individual provider in the NPPES registry on September 12, 2018.

Where is Raven Custalow located?

Raven Custalow practices at 7864 Richmond Tappahannock Hwy, Aylett, VA 23009. The listed phone number is (804) 769-2015.

What is Raven Custalow's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Is Raven Custalow enrolled in Medicare?

Yes. Raven Custalow is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Raven Custalow affiliated with any hospitals?

According to CMS data, Raven Custalow is affiliated with Bon Secours Memorial Regional Medical Center and Vcu Health Tappahannock Hospital.

When was this NPI record last updated?

The NPPES record for Raven Custalow was last updated on November 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.