Individual provider Active NPI

Paulette A Stewart, M.D

  • Internal Medicine Physician
  • Cambria Heights, NY
National Provider Identifier
1053336404
Registry record updated Jun 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
220296-1 Issued in NY
Practice address
22806 Linden Blvd
Cambria Heights, NY 11411
Phone
(718) 712-1219
Fax
(718) 712-1217
NPI assigned
Jul 13, 2006
Last updated
Jun 18, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 220296-1 NY Primary

Addresses

Primary practice location

22806 Linden Blvd
Cambria Heights, NY 11411

Mailing address

22806 Linden Blvd
Cambria Heights, NY 11411-1846
Phone (718) 712-1219

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040423000888 NY Practitioner - Internal MedicinePractitioner - Pediatric Medicine 3870589831 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
State University of New York Downstate Medical Center, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

22806 Linden Blvd
Cambria Heights, NY 11411-1846
Phone (718) 712-1219

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
220296-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Paulette a Stewart, MD PC Internal Medicine CurrentSince Apr 29, 2018 Accepting new patients

Locations

22806 Linden Blvd
Cambria Heights, NY 11411
Phone (718) 712-1219

22811 Linden Blvd
Cambria Heights, NY 11411
Phone (718) 712-1219

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DCFGCA/Endpoint/DCFGCA

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1053336404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22806 LINDEN BLVD",
            "city": "CAMBRIA HEIGHTS",
            "state": "NY",
            "postal_code": "114111846",
            "telephone_number": "718-712-1219",
            "fax_number": "718-712-1217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22806 LINDEN BLVD",
            "city": "CAMBRIA HEIGHTS",
            "state": "NY",
            "postal_code": "11411",
            "telephone_number": "718-712-1219",
            "fax_number": "718-712-1217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "PAULETTE",
        "middle_name": "A",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "220296-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambria Heights, NY

Sources for this page

Verify at the official NPI Registry.