Individual provider Active NPI

Kamilia Ait Belkacem, PA

  • Physician Assistant
  • Astoria, NY
National Provider Identifier
1003454117
Registry record updated Mar 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
2510 30TH Ave
Astoria, NY 11102-2448
Phone
(347) 862-8380
NPI assigned
Dec 19, 2019
Last updated
Mar 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

2510 30TH Ave
Astoria, NY 11102-2448

Mailing address

3811 Ditmars Blvd Apt 420
Astoria, NY 11105-1803
Phone (347) 862-8380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200413002676 NY Practitioner - Physician Assistant 9537599642 Reassigns benefits to 2 organizations
I20211209000177 FL Practitioner - Physician Assistant 9537599642 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aldad Medical PCGroup PAC ID 9234291436, 78 clinicians

Practice addresses (Care Compare)

27111 76TH Ave
New Hyde Park, NY 11040-1436
Phone (718) 289-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
024789NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Icahn School of Medicine at Mount Sinai CurrentSince Mar 8, 2020 Accepting new patients
Aldad Medical PC CurrentSince Aug 1, 2022 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Mar 8, 2020 Accepting new patients
Aldad Medical PC Physician Assistant CurrentSince Aug 1, 2022 Accepting new patients

Locations

801 Brickell Ave
Fl 8
Miami, FL 33131
Phone (305) 871-4420

1600 E 8th Ave
Ste A200
Tampa, FL 33605

2510 30th Ave
Long Island City, NY 11102
Phone (718) 267-4245

150 E 42nd St
Fl 10
New York, NY 10017
Phone (646) 605-8119

510 Hempstead Tpke
Rm 203
West Hempstead, NY 11552
Phone 51650572001051

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1576713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1003454117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 DITMARS BLVD APT 420",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111051803",
            "telephone_number": "347-862-8380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 30TH AVE",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111022448",
            "telephone_number": "347-862-8380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AIT BELKACEM",
        "first_name": "KAMILIA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-19",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

Verify at the official NPI Registry.