Individual provider Active NPI

Avi S. Laster, PA

  • Medical Physician Assistant
  • Nyack, NY
National Provider Identifier
1083665608
Registry record updated Aug 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
008653 Issued in NY
Practice address
160 N Midland Ave
Nyack, NY 10960-1912
Phone
(845) 685-0487
NPI assigned
May 16, 2006
Last updated
Aug 4, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 008653 NY Primary

Addresses

Primary practice location

160 N Midland Ave
Nyack, NY 10960-1912

Mailing address

651 W Mount Pleasant Ave
Livingston, NJ 07039-1600
Phone (973) 251-1086

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20060519000029 NY Practitioner - Physician Assistant 4082625413 Reassigns benefits to 2 organizations
I20201105001182 CT Practitioner - Physician Assistant 4082625413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Medical Associates, LLCGroup PAC ID 7214107515, 113 clinicians
Urgent Care Medical of New York LLCGroup PAC ID 5890071443, 40 clinicians

Practice addresses (Care Compare)

31 Old Route 7
Brookfield, CT 06804-1711
Phone (860) 650-3848

80 Route 6
Suite 704 705
Baldwin Place, NY 10505-1026
Phone (860) 650-3848

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
008653NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ahava Medical and Rehabilitation Center, LLC CurrentSince May 1, 2024 Accepting new patients
Hospitalist Emo of Ny, PC Past Accepting new patients
WRK Ventures, LLC Past Accepting new patients

Locations

2555 Nostrand Ave
Brooklyn, NY 11210
Phone 7189518800108

25 Carrier St
Liberty, NY 12754
Phone (718) 755-0332

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217808000000",
    "number": "1083665608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 W MOUNT PLEASANT AVE",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070391600",
            "telephone_number": "973-251-1086",
            "fax_number": "973-251-1109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 N MIDLAND AVE",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109601912",
            "telephone_number": "845-685-0487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASTER",
        "first_name": "AVI",
        "middle_name": "S.",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2008-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "008653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nyack, NY

Sources for this page

Verify at the official NPI Registry.