Raven Custalow, AGPCNP-BC
NPI 1669955019ActiveIndividual· Family Medicine· Aylett, VA
Family Medicine (AGPCNP-BC) in Aylett, Virginia, trained at Georgetown University School of Medicine (class of 2018). Their prescriptions cost Medicare Part D more than their services did: $199,366 for 3,224 claims, against $2,448 paid for services in 2024.
Overview
| NPI | 1669955019 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | AGPCNP-BC |
| Sole proprietor | No |
| NPI issued | Sep 12, 2018 |
| Last updated in NPPES | Oct 15, 2026 |
| Certified by provider | Oct 15, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | 0024176579 | VA |
| Nurse Practitioner, Primary Care | 363LP2300X | 0024176579 | VA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (TX) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 21 |
|---|---|
| Services billed | 48 across 12 procedure codes |
| Paid by Medicare | $2,448 |
Part D prescriptions in 2024
| Prescriptions (claims) | 3,224 · 6,219 30-day fills |
|---|---|
| Patients | 253 |
| Total drug cost | $199,366 |
| Generic share | 86% of claims |
Education and affiliations
| Medical school | Georgetown University School of Medicine |
|---|---|
| Graduation year | 2018 |
| Medicare specialty | Nurse Practitioner |
Medical group
- Upper Mattaponi Indian TribeAylett, VA · 5 clinicians
Hospital affiliations
- Bon Secours Memorial Regional Medical CenterMechanicsville, VA
- Vcu Health Tappahannock HospitalTappahannock, VA
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
Other family medicine physicians in Aylett
- 1184038705
- 1417117391
- 1265462782
- 1578651089
- 1043897689
- 1265469738
- 1295942308