Active NPI
Joseph Anselmo, PAC
- Physician Assistant
- New York, NY
National Provider Identifier
1073529129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0080561
- Practice address
- 1000 10TH Ave
Ste 5G-80
New York, NY 10019 - Phone
- (212) 523-6720
- Fax
- (212) 523-6115
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0080561 | NY | Primary |
Addresses
Primary practice location
1000 10TH Ave
Ste 5G-80
New York, NY 10019
Mailing address
PO Box 32870
Hartford, CT 06150
Phone (212) 523-6720
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0080561 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073529129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 32870",
"city": "HARTFORD",
"state": "CT",
"postal_code": "06150",
"telephone_number": "212-523-6720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 10TH AVE",
"address_2": "STE 5G-80",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10019",
"telephone_number": "212-523-6720",
"fax_number": "212-523-6115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANSELMO",
"first_name": "JOSEPH",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "0080561",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.