RAVEN CUSTALOW AGPCNP-BC
NPI 1669955019
Family Medicine in Aylett, VA
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 family medicine 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
Specialties & Licenses 2
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignment
Medicare enrollment records show Raven Custalow reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Aylett, VA 23009
- Reassigned Medicare billing, Texas enrollment
- 6 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
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, VAVcu Health Tappahannock Hospital
Acute Care Hospitals · Tappahannock, VAPhysician 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.
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.
Other Providers at the Same Location NPPES 11
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
AYLETT, VA 23009
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 Family Medicine with taxonomy code 207Q00000X.
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.
Which organization bills Medicare for Raven Custalow's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Raven Custalow reassigns Medicare benefits to Upper Mattaponi Indian Tribe (Aylett, VA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Raven Custalow's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Raven Custalow accept?
Health plans from Oscar Health list Raven Custalow as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
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 October 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 days 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.
# Raven Custalow, AGPCNP-BC · NPI 1669955019
Family Medicine physician in Aylett, Virginia. Individual provider, active in the CMS NPPES registry since September 12, 2018.
## Identity
- **NPI:** 1669955019 (Entity type: Individual)
- **Enumerated:** September 12, 2018
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 0024176579 (Virginia)
- **Sole proprietor:** No
## Practice location
- **Address:** 7864 RICHMOND TAPPAHANNOCK HWY, Aylett, VA 23009-3056
- **Phone:** (804) 769-2015
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Upper Mattaponi Indian Tribe (NPI 1750969168, Aylett, VA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Georgetown University School Of Medicine, class of 2018
## Record status
- **NPPES last updated:** October 15, 2026
- **Other identifiers:** Medicaid 3001529971 (VA)
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Source: [NPI Profile](https://npiprofile.com/npi/1669955019) · Data from the CMS NPPES public registry.