Individual provider Active NPI

Elisha Hinman, PA

  • Physician Assistant
  • Utica, NY
National Provider Identifier
1073928214
Registry record updated Jun 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
017576-1 Issued in NY
Practice address
1424 Genesee St
Utica, NY 13502-5101
Phone
(315) 724-6146
Fax
(315) 724-0308
NPI assigned
Jun 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2014

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 017576-1 NY Primary

Addresses

Primary practice location

1424 Genesee St
Utica, NY 13502-5101

Mailing address

568 Madison Ave
Apt 1 Basement
Albany, NY 12208-3695
Phone (518) 374-5353

Other identifiers 1

IdentifierTypeStateIssuer
017576-1OtherNYLICENSE

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170501000771 NY Practitioner - Physician Assistant 5597042523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Planned Parenthood of Greater New York IncGroup PAC ID 7810293297, 34 clinicians

Practice addresses (Care Compare)

1040 State St
Schenectady, NY 12307-1508
Phone (518) 382-5753

400 N Perry St
Johnstown, NY 12095-1115
Phone (516) 750-2500

543 Bay Rd
Queensbury, NY 12804-1441
Phone (516) 750-2500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
017576-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood of the Southern Finger Lakes Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403740800000",
    "number": "1073928214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "568 MADISON AVE",
            "address_2": "APT 1 BASEMENT",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122083695",
            "telephone_number": "518-374-5353",
            "fax_number": "518-347-1413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 GENESEE ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025101",
            "telephone_number": "315-724-6146",
            "fax_number": "315-724-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINMAN",
        "first_name": "ELISHA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-26",
        "last_updated": "2014-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017576-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "017576-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.