Raven Custalow, AGPCNP-BC - Medicare Nurse Practitioner in Aylett, VA

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Raven Custalow, AGPCNP-BC is a medicare enrolled "Nurse Practitioner - Primary Care" in Aylett, Virginia. Her current practice location is 7864 Richmond Tappahannock Hwy, Aylett, Virginia. You can reach out to her office (for appointments etc.) via phone at (804) 769-2015.

Raven Custalow is licensed to practice in Virginia (license number 0024176579) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1669955019.

Contact Information

Raven Custalow, AGPCNP-BC
7864 Richmond Tappahannock Hwy,
Aylett, VA 23009-3056
(804) 769-2015
Not Available

Map and Direction




Provider's Profile

Full NameRaven Custalow
GenderFemale
SpecialityNurse Practitioner - Primary Care
Location7864 Richmond Tappahannock Hwy, Aylett, Virginia
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1669955019
  • Provider Enumeration Date: 09/12/2018
  • Last Update Date: 11/08/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 0840543013
  • Enrollment ID: I20241104002126

Medical Identifiers

Medical identifiers for Raven Custalow such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1669955019NPI-NPPES
3001529971MedicaidVA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP2300XNurse Practitioner - Primary Care 0024176579 (Virginia)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Raven Custalow allows following entities to bill medicare on her behalf.
Entity NameUpper Mattaponi Indian Tribe
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750969168
PECOS PAC ID: 4880091446
Enrollment ID: O20210923002671

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Raven Custalow is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Raven Custalow, AGPCNP-BC
3944 Upshaw Rd,
Aylett, VA 23009-2912

Ph: (804) 928-8477		Raven Custalow, AGPCNP-BC
7864 Richmond Tappahannock Hwy,
Aylett, VA 23009-3056

Ph: (804) 769-2015

Reviews and Comments


Nurse Practitioner Nurses in Aylett, VA

Latricia Broaddus,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 5833 Richmond Tappahannock Hwy Ste 106b, Aylett, VA 23009
Phone: 042-230-0298    
Mrs. Molly Baldwin Massey, FNP-C
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 4917 Richmond Tappahannock Hwy Ste 1b, Aylett, VA 23009
Phone: 804-769-1245    Fax: 804-769-1342
Sara Eleanor Hooper Majewski, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 4917 Richmond Tappahannock Hwy Ste 1b, King William Medical Center, Aylett, VA 23009
Phone: 804-769-1245    Fax: 804-769-1342
Phyllis R. Sykes, NP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 11814 King William Rd, Aylett, VA 23009
Phone: 804-769-3022    Fax: 804-769-1253
Andrea Garrett, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 4917 Richmond Tappahannock Hwy Ste 1b, Aylett, VA 23009
Phone: 804-769-1245    
Dr. Britten White, DNP, FNP-C, PMHNP-C
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 359 Laurel Dr, Aylett, VA 23009
Phone: 804-258-1300    Fax: 804-258-1307

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.