Individual provider Active NPI

Adnan Isa, PA

  • Physician Assistant
  • New York, NY
National Provider Identifier
1063662559
Registry record updated Sep 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
009433-1 Issued in NY
Practice address
350 E 17TH St
16 Baird Hall- Dept of Surgery
New York, NY 10003-3805
Phone
(212) 420-2000
NPI assigned
Sep 22, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2008

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 009433-1 NY Primary

Addresses

Primary practice location

350 E 17TH St
16 Baird Hall- Dept of Surgery
New York, NY 10003-3805

Mailing address

350 E 17TH St
16 Baird Hall- Dept of Surgery
New York, NY 10003-3805
Phone (212) 420-2000

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110525000798 NY Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 7719163880

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
009433-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1222041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222387200000",
    "number": "1063662559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 E 17TH ST",
            "address_2": "16 BAIRD HALL- DEPT OF SURGERY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033805",
            "telephone_number": "212-420-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 E 17TH ST",
            "address_2": "16 BAIRD HALL- DEPT OF SURGERY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033805",
            "telephone_number": "212-420-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISA",
        "first_name": "ADNAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-22",
        "last_updated": "2008-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "009433-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.