Individual provider Active NPI

Mable Cheng, PA

  • Physician Assistant
  • Hollis, NY
National Provider Identifier
1053960161
Registry record updated Jul 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
023936 Issued in NY
Practice address
8123 189TH St
Hollis, NY 11423-1036
Phone
(718) 371-8009
NPI assigned
Sep 11, 2019
Last updated
Jul 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 023936 NY Primary

Addresses

Primary practice location

8123 189TH St
Hollis, NY 11423-1036

Mailing address

8123 189TH St
Hollis, NY 11423-1036
Phone (718) 371-8009

Other practice location 1

4502 82nd St
Elmhurst, NY 11373-3558
Phone (718) 779-2248

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
023936NYMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1568160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656720000000",
    "number": "1053960161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8123 189TH ST",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114231036",
            "telephone_number": "718-371-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8123 189TH ST",
            "city": "HOLLIS",
            "state": "NY",
            "postal_code": "114231036",
            "telephone_number": "718-371-8009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4502 82nd St",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "NY",
            "postal_code": "113733558",
            "country_code": "US",
            "telephone_number": "718-779-2248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHENG",
        "first_name": "MABLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-11",
        "last_updated": "2022-07-02",
        "certification_date": "2022-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "023936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollis, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2022; 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.