Kenneth Michael Pfeifer, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

23-008853 Issued in NY

Practice address

270-05 76TH Avenue
Anesthesia Department
New Hyde Park, NY 11040

Phone

(718) 470-7390

Fax

(516) 470-7307

NPI assigned

Oct 22, 2010

Last updated

Oct 22, 2010By 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 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

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

Interoperability endpoints

• Direct secure messaging: kennethpfeifer@nslijmedgr.allscriptsdirect.net

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.

• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment NPD

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287705600000",
    "number": "1063712198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270-05 76TH AVENUE",
            "address_2": "ANESTHESIA DEPARTMENT",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "11040",
            "telephone_number": "718-470-7390",
            "fax_number": "516-470-7307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270-05 76TH AVENUE",
            "address_2": "ANESTHESIA DEPARTMENT",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "11040",
            "telephone_number": "718-470-7390",
            "fax_number": "516-470-7307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFEIFER",
        "first_name": "KENNETH",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-22",
        "last_updated": "2010-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "23-008853",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "002480",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Petrossian
• Martha Alexandra Pettei
• Michael Pettei
• Michael Edward Pettei, MD
• Forouhideh Peyvandi, M.D.
• Dat Hung Pham, MD
• Daphne Phanord
• Alan Mathew Philip
• Aleyamma Philip, LMSW
• Arpan Philip, M.D.

• Physician Assistant in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.