Individual provider Active NPI

Michelle Sophy Huck, PA-C

  • Surgical Physician Assistant
  • Harrison, NY
National Provider Identifier
1053957415
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
024434-01 Issued in NY
Practice address
440 Mamaroneck Ave Ste 412
Harrison, NY 10528-2429
Phone
(914) 761-7070
NPI assigned
Nov 20, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 024434-01 NY Primary

Addresses

Primary practice location

440 Mamaroneck Ave Ste 412
Harrison, NY 10528-2429

Mailing address

440 Mamaroneck Ave Ste 412
Harrison, NY 10528-2429
Phone (914) 761-7070

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200211000881 NY Practitioner - Physician Assistant 3678909629 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cosmetic Surgery Associates of New York PLLCGroup PAC ID 5092871509, 5 clinicians

Practice addresses (Care Compare)

440 Mamaroneck Ave
Suite 412
Harrison, NY 10528-2429
Phone (914) 328-7802

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
024434-01NYMDCognitive & Behavioral Psychologist
024434NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cosmetic Surgery Associates of Westchester, PLLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1574208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1053957415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 MAMARONECK AVE STE 412",
            "city": "HARRISON",
            "state": "NY",
            "postal_code": "105282429",
            "telephone_number": "914-761-7070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 MAMARONECK AVE STE 412",
            "city": "HARRISON",
            "state": "NY",
            "postal_code": "105282429",
            "telephone_number": "914-761-7070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUCK",
        "first_name": "MICHELLE",
        "middle_name": "SOPHY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-20",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "024434-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrison, NY

Sources for this page

Verify at the official NPI Registry.