Individual provider Active NPI

Cheryl Tepfer, PA-C

  • Physician Assistant
  • Far Rockaway, NY
National Provider Identifier
1093174740
Registry record updated Nov 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
019544 Issued in NY
Practice address
712 Beach 20TH St
Far Rockaway, NY 11691-3502
Phone
(718) 471-0200
NPI assigned
Feb 22, 2016
Last updated
Nov 26, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2016

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 019544 NY Primary

Addresses

Primary practice location

712 Beach 20TH St
Far Rockaway, NY 11691-3502

Mailing address

1735 Willow CT
First Floor
Far Rockaway, NY 11691-6200
Phone (646) 477-9633

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
I20170111001497 NY Practitioner - Physician Assistant 7719268440

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019544NYMDPhysician Assistant

Networks

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

NPI Registry JSON

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

{
    "created_epoch": "1456099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480118400000",
    "number": "1093174740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 WILLOW CT",
            "address_2": "FIRST FLOOR",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116916200",
            "telephone_number": "646-477-9633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 BEACH 20TH ST",
            "city": "FAR ROCKAWAY",
            "state": "NY",
            "postal_code": "116913502",
            "telephone_number": "718-471-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEPFER",
        "first_name": "CHERYL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-22",
        "last_updated": "2016-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Far Rockaway, NY

Sources for this page

Verify at the official NPI Registry.