Iris Ben Artin, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00536100 Issued in NJ

Practice address

29 W High St
East Hampton, CT 06424-1024

Phone

(617) 958-5697

NPI assigned

Sep 6, 2019

Last updated

Jun 8, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Miroslav Jurisic Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/22378/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1567728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1063061604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BOSTON PL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021084407",
            "telephone_number": "617-953-7243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 W HIGH ST",
            "city": "EAST HAMPTON",
            "state": "CT",
            "postal_code": "064241024",
            "telephone_number": "617-958-5697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARTIN",
        "first_name": "IRIS",
        "middle_name": "BEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-06",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "4440",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "023789",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00536100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIROSLAV",
            "last_name": "JURISIC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel Agyemang
• Chayna Marie Aldi, BCBA
• Madison Leola Anderson, LMSW
• Christopher Michael Antoszek, PHARM.D.
• Apex Educational Solutions, LLC
• Jon Joel Avery, PHARMD
• Belltown Counseling
• Belltown Physical Therapy and in-Home Rehabilitation LLC
• Donna L Benard, MA MFT INTERN
• Helen Bonoff, BCABA

• Physician Assistant in East Hampton, CT
• Providers in East Hampton, CT by specialty
• Physician Assistant in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; 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.