Emmanuel Agnant, PA
Individual provider Active NPI Physician Assistant · Elmhurst, NY
NPI 1043488943 · NPPES record last updated Mar 13, 2026
Key facts
- NPI
- 1043488943
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 012529 (NY)
- Practice address
- 4012 80TH St
Elmhurst, NY 11373-1234 - Phone
- (718) 886-9000
- Fax
- (718) 961-0666
- NPI assigned
- Feb 13, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110728000429 | NY | Practitioner - Physician Assistant | 9931377439 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| George Romar MD PLLC | Current |
Accepting new patients | |
| Dial Doc Now Medical Group PC | Past |
Accepting new patients | |
| Metro Dermatology of NJ,PA | Past | Accepting new patients |
Locations
65 Fort Washington Ave
Apt 1B
New York, NY 10032
Phone (718) 872-9400
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/IGJFCD/Endpoint/IGJFCD
- https://fhir4.healow.com/fhir/r4/AJJAED/Endpoint/AJJAED
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 012529 | NY | Yes |
Addresses
Primary practice location
4012 80TH St
Elmhurst, NY 11373-1234
Mailing address
194 Winding Brook Rd
New Rochelle, NY 10804-1926
Phone (718) 865-8733
Other practice location 1
65 Fort Washington Ave Apt 1B
New York, NY 10032-4644
Phone (718) 872-9400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00246075 | Medicaid | NY |
Other providers in Elmhurst, NY
- Oscar Afre
- Nasrin Afroz
- Muhammad Tehsin Afzal
- Kunal Aggarwal
- Anto Aghjayan
- Surbhi Agrawal
- George A. Agriantonis
- Joyce Stephanie Aguaiza
- Reyna Aguilar
- Angel Aguilera
All providers in Elmhurst, NY · Physician Assistant in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.