Active NPI
Dane McCarthy
- Physician Assistant
- Bronx, NY
National Provider Identifier
1003481367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 027308
- Practice address
- 111 E 210TH St
Bronx, NY 10467-2401 - Phone
- (718) 920-5731
- NPI assigned
- May 20, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 027308 | NY | Primary |
Addresses
Primary practice location
111 E 210TH St
Bronx, NY 10467-2401
Mailing address
9905 63Rd Dr Apt 9Aa
Rego Park, NY 11374-2485
Phone (808) 753-6380
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | EPIC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 027308 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Montefiore Medical Center | Current | Accepting new patients | |
| New York University | Current | Accepting new patients | |
| New York University | Current | Accepting new patients | |
| Montefiore Medical Center | Current | Accepting new patients |
Locations
111 E 210th St
Bronx, NY 10467
300 Community Dr
Plandome, NY 11030
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
Interoperability endpoints
- dmccarthy557626@nyumc.direct-ci.com
- dmccarthy1528686@nychhc.direct-ci.com
Organizations & group practices 7
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Anesthesiology Physician
- Bronx, NY
- NPI 1063525152
-
- Emergency Medical Services (Emergency Medicine) Physician
- Bronx, NY
- NPI 1689618407
-
- Urology Physician
- Great Neck, NY
- NPI 1053688572
-
- Registered Dietitian
- New York, NY
- NPI 1013375526
-
- Community/Retail Pharmacy
- Bronx, NY
- NPI 1194183715
-
- Physical Medicine & Rehabilitation Physician
- Boynton Beach, FL
- NPI 1104787613
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639526400000",
"number": "1003481367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9905 63RD DR APT 9AA",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113742485",
"telephone_number": "808-753-6380"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 E 210TH ST",
"city": "BRONX",
"state": "NY",
"postal_code": "104672401",
"telephone_number": "718-920-5731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCARTHY",
"first_name": "DANE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-20",
"last_updated": "2021-12-15",
"certification_date": "2021-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "027308",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "EPIC",
"affiliation": "N",
"address_1": "111 E 210th St",
"city": "Bronx",
"state": "NY",
"country_code": "US",
"postal_code": "104672401",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Bronx, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.