NPIMap

Organization Active NPI

Joseph Reale Physician Assistant PC

  • Surgical Physician Assistant
  • Kings Park, NY
National Provider Identifier
1013147800
Registry record updated Jul 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
004677 Issued in NY
Legal business name
JOSEPH REALE PHYSICIAN ASSISTANT PC
Practice address
12 Alfred LN
Kings Park, NY 11754-5013
Phone
(516) 532-7805
Fax
(973) 291-4439
NPI assigned
Jul 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2009

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

Authorized official

Name
Joseph Reale, PANPI 1962493668
Title
Owner
Phone
(516) 532-7805

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AS0400X 004677 NY Primary

Addresses

Primary practice location

12 Alfred LN
Kings Park, NY 11754-5013

Mailing address

12 Alfred LN
Kings Park, NY 11754-5013
Phone (516) 532-7805

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1247616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247616000000",
    "number": "1013147800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 ALFRED LN",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117545013",
            "telephone_number": "516-532-7805",
            "fax_number": "973-291-4439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 ALFRED LN",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117545013",
            "telephone_number": "516-532-7805",
            "fax_number": "973-291-4439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH REALE PHYSICIAN ASSISTANT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-15",
        "last_updated": "2009-07-15",
        "status": "A",
        "authorized_official_last_name": "REALE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-532-7805",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "004677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kings Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.