INNOVATIVE REHABILITATION CONSULTANT MEDICAL PC
NPI 1770880403
Clinic/Center - Pain in Rego Park, NY
About Innovative Rehabilitation Consultant Medical Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
INNOVATIVE REHABILITATION CONSULTANT MEDICAL PC (NPI 1770880403) is a healthcare organization registered as a pain in Rego Park, New York and active in the NPI registry since February 2011. The organization lists Dmitriy Fuzaylov, Ownder, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Innovative Rehabilitation Consultant Medical Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
7Medicare enrollment records show 7 clinicians reassign Medicare billing to Innovative Rehabilitation Consultant Medical PC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 6 within 10 miles. They are listed nearest first.
Clinicians, nearest first (7)
Forest Hills, NY 11375
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Innovative Rehabilitation Consultant Medical PC's NPI number?
The NPI number for Innovative Rehabilitation Consultant Medical PC is 1770880403. It was assigned to this organization in the NPPES registry on February 15, 2011.
Where is Innovative Rehabilitation Consultant Medical PC located?
Innovative Rehabilitation Consultant Medical PC is located at 9701 66th Ave, Rego Park, NY 11374. The listed phone number is (718) 275-5200.
What is Innovative Rehabilitation Consultant Medical PC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Pain, with taxonomy code 261QP3300X.
Is Innovative Rehabilitation Consultant Medical PC enrolled in Medicare?
Yes. Innovative Rehabilitation Consultant Medical PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Innovative Rehabilitation Consultant Medical PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 7 clinicians in 3 Medicare specialties reassign their Medicare billing to Innovative Rehabilitation Consultant Medical PC. A 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 the clinician's services. The largest specialties are Physical Therapist in Private Practice (4), Nurse Practitioner (2) and Pain Management (1). Of these, 1 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Innovative Rehabilitation Consultant Medical PC was last updated on July 9, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.
# Innovative Rehabilitation Consultant Medical Pc · NPI 1770880403
Pain organization in Rego Park, New York. Organization record, active in the CMS NPPES registry since February 15, 2011.
## Identity
- **NPI:** 1770880403 (Entity type: Organization)
- **Enumerated:** February 15, 2011
- **Primary specialty:** Clinic/Center - Pain · taxonomy 261QP3300X
- **Organization subpart:** No
- **Authorized official:** Dmitriy Fuzaylov, OWNDER
## Practice location
- **Address:** 9701 66TH AVE, Rego Park, NY 11374-4245
- **Phone:** (718) 275-5200
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 7 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Physical Therapist in Private Practice (4), Nurse Practitioner (2), Pain Management (1); 1 practice at this address and 6 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 9, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1770880403) · Data from the CMS NPPES public registry.