Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ekaterina Khaytsis, NP

Individual provider Registered Nurse · NPI 1417422395

Ekaterina Khaytsis, NP is a Nurse Practitioner in Brooklyn, New York. Qualified in 2023, 3 years ago. Practices with Revived Soul Medical PC, a 15-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
3
Licensed in
NY
In the registry since
2018
Specialties on file
3
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

1329 E 17th St Ste 1
Brooklyn, NY 11230-6052
Phone: (718) 382-5060
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 405544 (NY)
Registered Nurse Taxonomy 163W00000X · Licence 720868 (NY)
Primary Care Nurse Practitioner Taxonomy 363LP2300X · Licence F348863-01 (NY)

Record details

NPI number1417422395
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorYes
NPI enumeratedOctober 8, 2018
Last updated in NPPESJune 3, 2024
Certification dateJune 3, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Revived Soul Medical Pc — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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